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r
K.HIIll. . IIADCL.
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jR o r^
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THE
MEDICAL WORKS
OF
PATJLUS iEGINETA,
T H K a II K R K P H Y S I CI A N.
TRANSLATED INTO ENGLISH:
WITH
A COPIOUS COMMENTARY,
COXTAIKINC
A COMPRPMIENSIVE VIRW OF THK KNOWLKDGK POSSKSSKI) liV THE
CiREEKS ROMANS, AND ARABIANS. ()N ALL SUBJPXTS
CONNECTED WITH MEDICINE AND SLRCJERV.
VOL. L
By FRANCIS ADAMS, Esq.
SURGEON,
AUTHOR OF <<nKKME8 PJIILOLOCrS," &<•.
*' Multum egeruut qui ante nos fueniiit, sed nun peregenint. ^NUspicieiuU tuiiieu
sunt, et ritu Deonim oolendi." — Sknkca.
LONDON:
J. WELSH ; TREUTTEL, WURTZ. & CO. LONDON ;
ADAM & CHARLES BLACK, EDLNTBURGH ;
HODGES & SMITH, DUBLIN;
AND A. BROWN & CO. ABERDEEN.
MDCCCXXXIV.
ABERDKRN :
I'RIXTED BY G. CORNWAIX,
HERALD OFFICF.
INsrniBKD TO
JOHN ABERCROMBIE, Esq. M. D. Edinburoh,
ANU
G. J. GUTHRIE, Esq. Surgeon, London,
IN TESTIMONY OF
ESTEEM FOR THEIR LITERARY AND PROFESSIONAL CHARACTERS,
AND OF GRATITUDE FOR THE FRIENDLY INTEREST
WHICH THEY HAVE TAKEN IN THE PRESENT PUBLICATION,
BY THEIR OBLIGED AND FAITHFUL SERVANT,
THE EDITOR.
Ban<hoby-Terxam, Nov. 12, 1833.
THE EDITOR'S PREFACE.
Notwithstanding ihe efforts which have been made of late years to im«
prove the Medical Literature of this country, it will still be admitted, I am
convinced, that there is not, in the English language, any work which con-
tains a full and accurate account of the Theoretical and Practical knowledge
possessed by the Greeks, Romans, and Arabians, on all matters connected
with Medicine and Surgery. Nor, as far as I can learn, is the case much
different with the Continental languages; for, altliough the German and
French have lately acquired several Histories of Medicine distinguished
for considerable ability and research, the object of all these works would
appear to have been confined to a general exposition of the leading disco-
veries and revolutions in doctrine which marked every particular age or
epoch in the profession; and I will venture to atfirm that no person will be
able to acquire from a perusal of them any thing like a competent acquaint-
ance with the minute detail of ancient practice. The design of the present
publication is to supply this deficiency, by giving a complete Manual of the
Surgery and Medicine of the Ancients, with a brief but comprehensive out-
line of the sciences intimately connected with them, especially Physiology,
the Materia Medica, and Pharmacy. At first it was my intention to do this
in the form of an original work, but, being perplexed with the multiplicity of
matters which I had to treat of, I at last resolved upon taking for ray text-
book the celebrated Treatise of Paulus JEciklta, whereby I was at once
supplied with a convenient arrangement of my subject, at the same time that
I enriched our Medical Literature with the translation of one of the most
valuable relicts of ancient science. By following this correct and faithful
guide — ^by supplying his omissions and enlarging his plan, when necessary —
yi THE KDIT0R*8 PREFACE.
and by adding, in all cases, the improvements of several subsequent ages — I
trust that I have been able to present the reader with a work from which he
may, at one view, become familiar with the prevailing opinions of the pro-
fession upon all the most important points of Medical Practice during a
period of more than fifteen centuries. Impressed with the importance of the
task which I had undertaken, I have endeavoured to discharge it faithfully
to the best of my ability ; and have, therefore, overlooked no Treatise con-
nected in anywise with the Medical Art which has come down to us from
antiquity, and have further availed myself freely of the learned labours of a
number of modem Commentators, especially on the department of the Ma-
teria Medica, in order to adapt the nomenclature of the ancients on these
subjects to the present state of Botany, Chemistry, and Mineralogy.
As to the original authors from whose stores I have drawn so freely, un-
less I am much blinded by partiality for the pursuits in which I have been
lately engaged, they will be found, upon an intimate acquaintance with them,
to have been well entitled to the confidence and reputation which they long
enjoy«i], and to which it is my wish and hope that the present publication
should, to a certain degree, restore them. It appears to me that, at certain
periods of ancient times, the standard of professional excellence was such as
would not easily be attained at the present day with all our vaunted im-
provements iu education ; and that many of these early masters of our Art
were distinguished for varied stores of erudition, an ardent love of truth, and
an aptitude to detect the fallacies of error, such as few of us even now can
lay claim to. The Father of Medicine held that, to become an eminent phy.
sician, it was necessary not only to be well acquainted with the structure of
the human frame, but also to be skilled in Logic, Astronomy, and other
Sciences; and of him it may be asserted, that he sought after scientific truth
upon the strict principles of the Inductive philosophy more than two thousand
years before the world gave Lord Bacon the credit of introducing this me-
thod of philosophizing. His devoted admirer and follower, Galen, was
evidently the very beau ideal of an accomplished physician — skilled in all
the sciences of the day, in Logic, Mathematics, Rhetoric, and the First Phi-
losophy;— to all these ornamental branches of knowledge he added a minute
THB bditoh's prkpack. ri\
acquaintaoce with Anatomy and Physiology; a practical experience with
the phenomena of diseases as diversified by climate, situation, and the Ta-
ried modes of life; a singular perseverance in collecting facts; and an extra-
ordinary ability for generalising them. The cotemporaries of Celsus declare
of him that he was not only well acquainted with Medical Literature but
also minutely skilled in every elegant and useful science which was known
and cultivated at that remarkable period. And Rhases, the Arabian, requires
of bim who aspires to eminence in the Medical profession, that, instead of
wasting his earlier years in frequenting musical and drinking parties, he
should have spent them in conning over the valuable records of ancient wis-
dom. ^ But the Sciolist," says he, '* who gives himself out for a proficient
in the Art, while be has scarcely even a smattering of learning, will never be
deserving of much confidence, nor ever attain any great eminence in his
profession. For it can never be that any individual, to whatever age he may
reach, should be able to comprehend in his mind a subject so vast and dif-
fuse, except by treading upon the footsteps of the ancients ; since the boun-
daries of the science far exceed the narrow limits of the life of man, as is the
case with most of the liberal arts as well as with Medicine. The number of
authors is not small by whose labours the Art has attained its present
growdi ; and yet one may hope to master the monuments of their industry
within the space of a few years. Let us suppose that, in the course of a
thousand years, a thousand authors had made improvements in the profes-
sion ; and then a person who has diligently studied their works may im-
prove his mind as much in knowledge as if he had devoted a thousand years
to the study of Medicine. But, when an acquaintance with former authors
is despised, what need be expected from the efforts of a single person ? For,
however much he may surpass others in abilities, how is it to be supposed
that his private stock of knowledge should be at all worthy to compare
with the accumulated treasures of antiquity ? In a word, he who has never
turned over the pages of the ancient physicians, nor has formed to his mind
a distinct conception of the nature of diseases before he enters the chambers
of the sick, will find that, from ignorance and misapprehension, he will con-
viii THE editor's prkfack.
found one complaint with another, for this obvious reason, tltat he has come
to his task unprepared and uninstructed /'
The reader will not fail to remark, in the course of his investigations, that
there is no legitimate mode of cultivating Medical Knowledge which was not
followed by some one or other of the three great Sects into which the profession
was divided in ancient times. The Empirics held that Observation, Experi-
ment, and the application of known remedies in one case to others pre-
sumed to be of a similar nature, constitute the whole art of cultivating
Medicine. Though their views were narrow, and tljeir information scanty,
when compared with some of the chiefs of the other sects ; and, although they
rejected, as useless and unattainable, all knowledge of the causes and recon-
dite nature of diseases ; it is undeniable that, besides personal experience
they freely availed themselves of historical detail, and of a strict analogy
founded upon observatiort and the resemblance of phenomena. To this
class we may refer Scribonius Largus, Marcel lus, Plinius Valerianus,
and a few others, frequently quoted by us. The sect called the Rational,
Logical, or Dogmatical, holding that there is a certain alliance and con-
nexion among all the useful and ornamental arts^ maintained that it is the
duty of the physician not to neglect any collateral science or subject.
They therefore inquired sedulously into the remote and proximate causes of
diseases, and into the effects of Airs, Waters, Places, Pursuits, Food, Diet, and
Seasons, in altering the state of the human body, and in rendering it more or
less susceptible of morbid changes. Looking upon general rules as not
being of universal application, they held that the treatment ought to be mo-
dified according to the many incidental circumstances under which their pa-
tients might be placed. They freely and fully availed themselves of whatever
aid they could derive from Experience, Analogy, and Reasoning. Hippo-
crates, Galen, Aetius, Oribasius, Paulus iEgineta, Aetuarius, and all the
Arabian authorities, may be looked upon as belonging to this sect. The Pneu-
matic sect, to which Aretseus belonged, was nearly allied to the Dogmatic.
The sect of the Methodists, rejecting altogether the consideration of remote
causes, which they held to be of Tio importance to the cure, and giving them-
selves up lo too bold a classification of diseases, according to certain hy()o-
THK editor's PRSFACK. Ix
thetical states of the body in which they were supposed to originate,
fettered themselves too much with a few general rules, which they held to be so
universally applicable, that they would scarcely allow of their being modified
by incidental cirrtumstances in any possible contingency. Notwithstanding this
defect, it is undeniable that their speculations as to the nature of diseases are
generally very acute, and their modes of treatment frequently very rationaL
Upon the whole, the general outline of their system would appear to have
borne a striking resemblance to that of the sect which started up in Edin-
burgh about forty years ago, called the Brunonian, from the name of its
ingenious but fanciful founder Dr. Brown. The only perfect model of ai»-
cient Methodism that has come down to us is Cslius Aurelianus, an author
so truly eminent that some of his admirers in modern times have not scrupled
to maintain that his works are even better worth being attentively studied
than those of Hippocrates and Galen. Moschion, and Theodore Priscian
otherwise known by the name of Octavius Uoratianus, likewise belonged to
this sect ; Alexander of Tralles also had a considerable leaning to its princi-
ples ; and some would even refer the illustrious Celsus to the same class ; but
this author would seem to have imbibed the genuine spirit of Eclecticism,
and, like his distinguished correspondent Horace, to have been
ti
Nollius addictus jurare in verba magistri.*'
Before concluding these Prefatory remarks, it will be naturally expected
that I should say something of the author whose work I have bestowed so
much pains in translating and commenting upon. Here, however, I must
regret that the information which I have to supply is exceedingly scanty and
unsatisfactory. So little is known of him that it is not even ascertained in
what century he flourished. Vossius is wholly undecided; Moreau and Le
Clerc place him in the fourth century; Vander Linden and Conringius, in
the fifUi ; but Freind, Albertus Fabricius, Hutcheson, Sprengel, and most of
the late writers of the Ancient History of Medicine, bring him down as low as
the seventh century, upon the authority of Abulfaragius ; an author, however,
who, on many occasions, betrays such gross ignorance of chronology that no
X THB EDITORS PRBFACK.
reliance ought to be put on any opinion of his on these matters. What con-
fidence does a writer deserve who states, for example, that Andromachus,
the physician who added the flesh of vipers to tlie celebrated Electuary of
Mithridates, lived in the time of Alexander the Great ! — that Dioscorides of
Ain Zarba flourished in the reign of Ptolemy Physcon, namely, about 120
years before Christ, whereas it can scarcely admit of a doubt that the cele-
brated author of the Greek Materia Medica did not live earlier than the end
of the first century of the Christian jEral — and that Ruff'us was coteraporary
with Plato, when we have the authority of Suidas that he lived in the reign
of Trajan I Dr. Milward, in his Epistle to Sir Hans Sloane, endeavours to
settle the age of our author from the following train of inferences : — In the
first place, then, since Paulus quotes Trallian, and Trallian, Aetius, it is quite
certain that our author was posterior to both these writers. Now the age
of Aetius may be made out from the following circumstances: — Aetius
mentions St. Cyril, Archbishop of Alexandria, whose death is ascertained
from Ecclesiastical History to have happened as late as the middle of
the fifth century. Nay, he also takes notice of a medicine much recom-
mended by Petrus Archiater, chief physician toTheodoric, who was posterior
to St. Cyril. We cannot possibly suppose it likely, then, that Aetius flourish-
ed earlier than the end of the fifth century. But what brings him still further
down is the circumstance of his predecessor, Trallian, being mentioned by
Agathias, the Historian, about the year 565. It would seem almost certain,
therefore, that our author cannot have lived at an earlier period than the end
of the sixth or the beginning of the seventh century.
But, whatever may have been the period at which he lived, there can be no
doubt that he attained great eminence in his profession, and continued to be
looked up to as one of the highest authorities in Medicine and Surgery dur-
ing a long succession of ages. His countryman Nonnus, although, if I recol-
lect right, he does not mention him by name, gives a brief compendium of a
considerable portion of his work ; and Psellus does the same in Leonine
yerses. All the medical authors, in a word, of the distinguished Arabian
period, quote his opinions in almost every page of their works, and never
fail to recognise him as one of the most trust-worthy of their Grecian masters.
THB editor's prbfacb. xi
At the revival of Litei^ture in modern times, the Latin Translations of the
Arabians continued for a time to be the ordinary guides to practice ; but
when the superior merit of their Greek originals came to be properly appre-
ciated, our author rose again into high consideration. As a proof of this, t
may mention that the Surgery of Fabrice d'Aquapendente is made up almost
entirely from his works. Portal, therefore, had no good occasion for repre-
senting him as '' one of those unfortunate writers to whom posterity had not
done justice.*' I admit, indeed, that for some time past, since professional
research and the study of ancient models have been superseded by a restless
desire of novelty in Theory and in Practice, he has not enjoyed that considera-
tion to which he is justly entitled ; but, in this respect, he has only shared
the fate of other names, equally eminent for their contributions to Medical
Science, who have now been suffered to fall into neglect.
Of the Latin Translations of his works, the most celebrated is that of Cor-
narius, published by Henry Stephens in his Medica ArtU Principts ; but
which, af^er a careful examination, I have not found to be so trust-worthy as
I expected to find it. There once existed an Arabic Edition by Honain, a
Syrian Physician, but of it I know nothing. The only part which has been
translated into any modem language is the Sixth Book, a French Translation
of which was published at Lyons, A. D. 1539. Of the Original there are
two Editions, namely, the Aldine of 1528 and the Basle of 1538, neither of
which is so accurate as could be wished.
To many individuals and literary bodies my best thanks are due, for the
facilities which they afforded me of consulting certain scarce books, which
otherwise I should have found difficulty in procuring access to. I feel par-
ticularly indebted to ^. H. Barker, Esq. of Thetford, not only for assistance
rendered to me in this way, but al&o for much important advice on many
points connected with classical literature.
Banchory-Tehkak,
November 12, 1833.
PAULUS iEGINETA.
THE AUTHOR'S PREFACE.
It is not because the more ancient Writers hail omitted any tiling leialive to
the Art that I have composed this Work, but for the purpose of giving a
compendious course of instruction. For, on the contrary, every thing is
handled by them in a proper manner, and without any omissions, whereas the
modems have not oAly in tiie first place neglected the study of them, but
have also blamed them for prolixity. VVherefore, I have undertaken the fol-
lowing Treatise, which, as is like, will serve as a Commentary to those who
may choose to consult it, whilst it will prov« an exercise to me. For it appears
wonderful that Lawyers should be possessed of compendious, and, as they
call them, popular legal Synopses, in which are contained the heads of all
the Laws, to serve for immediate use, whilst we neglect these things, although
they have it generally in their power to put off the investigation of any point
for a considerable time, whereas we can seldom or rarely do so ; for in many
cases'necessity requires that we act promptly, and hence Hippocrates has
proi>erly said, "The season is brief." For their business is generally con-
ducted in the midst of cities, where there is an abundant supply of books,
whereas physicians have to act not only in cities, in the fields, and in desert
places, but also at sea onboard of ships, where such diseases sometimes sud-
denly break out as, in the event of procrastination, would occasion death, or at
least incur the most imminent danger. But to remember all the rules of the
healing art, and all the particular substances connected with it, is exceedingly
difficult, if not altogether impossible. On this account, 1 have collected this
Epitome from the works of the ancients, and have set down little of my own,
except a few things which I have seen and tried in the practice of the art. For
being conversant with the most distinguished writers in the profession, and
2
in particular with Oribasius, who, in one work, gave a select view of every
thing relating to health, (he being posterior to Galen, and one of the more
modem authors,) I have collected what was best in them, and have endea-
voured, if possible, not to pass by any one distemper. For the work of
Oribasius, comprehending 70 books, contains indeed an exposition of the
whole art, but it is not easily to be procured on account of its bulk, whilst
the epitome of it, addressed to his son, Eustathius, is deficient in some dis-
eases altogether, and gives but an imperfect description of others, sometimes
the causes and diagnosis being omitted, and sometimes the proper plan of
treatment being forgotten, as well as other things which have occurred to my
recollection. Wherefore, the present work will contain the Description,
Causes, and Cure of all diseases, whether situated in parts of uniform tex-
ture, in particular organs, or consisting of solutions of continuity, and that
not merely in a summary way, but at as great length as possible. But in
the first place, we will give an exposition of every thing that relates to Health
and Regimen. The last book contains an account of simple and compound
Medicine?.
CONTENTS
or THK
WHOLE SEVEN BOOKS OF THIS WORK.
In the First Book, you will find every thing that relates to Hygiene, and to
the preservation from, and correction of, distempers peculiar to the various
ages, seasons, temperaments, and so forth. Also, the powers and uses of the
different articles of food, as we have explained in a summary manner.
In the Second is explained the whole doctrine of Fevers, an account of
certain matters relating to them being premised, such as excrementitious
discharges, critical days, and other appearances, and concluding with certain
symptoms which are sometimes the consequences of fever.
The Third Book relates to Topical affections, beginning from the crown of
the head and descending down to the nails of the feet
The Fourth Book treats of those complaints which are external and ex-
posed to view, and are not limited to one part of the body. Also, of Intes-
tinal Worms and Dracunculi.
The Fifth treats of the Wounds and Bites of venemous Animals ; also of
the distemper called Hydrophobia, and of persons bitten by dogs which are
mad, and by those which are not mad ; and also of persons bitten by men.
Among other things, it treats of deleterious substances, and the preservatives
from them.
In the Sixth is contained every thing relating to Surgery, both what re-
lates to the fleshy parts, such as the extraction of weapons ; and to the bones,
which comprehends fractures and dislocations.
In the Seventh is contained a description of the Properties of all Medi-
cines, first of the simple, then of the compound ; particularly of those which
I had mentioned in the preceding six bo<^s, and more especially the greater
and, as it were, celebrated preparations. For I did not think it proper to
treat of all these articles promiscuously, lest it should occasion confusion,
but so that any person looking for one or more of the distinguished prepara*
tions might easily find it. Towards the end are certain things connected with
the composition of medicines, and of those articles which may be substituted
B 2
for one another, the whole concluding with an account of weights and mea-
sures. We proceed to the First Book.
In this the First Book, as we stated in the Preface, and as will be described
afterwards more particularly, is contained an account of every thing relating
to the preservation of Health. We shall only premise, that in the 1st and 2d
Books almost every thing is taken from Oribasius. For I mean not to seek
after fame for myself, but to collect what is useful from all quarters. In the
remaining five Books, little or nothing is borrowed from him.
HEADS OF THE FIRCT BOOK.
1. On the Complaints of Pregnant Women, and their Regimen.
2. On the Nurse.
3. On the Milk of the Nurse.
4. How to correct bad Milk.
5. On the Nurture of the Infant.
6. On the Eruptions which happen to Infants.
7. On the Cough and Defluxion of Infants.
8. On Pruritus of the Skin.
9. On Dentition..
10. On Aphtha, orThrush.
11. On Excoriation of the Thighs.
12. On Watery Ears.
13. On Siriasis.
14. The Diet of Infants, and of the succeeding ages, until manhood.
15. On the Preparatory Friction.
16. On Exercise.
17. On the kinds of Exercise.
18. On the kinds of Friction.
1 9. On Vociferation.
20. On Lassitude from Exercise.
21. On Constriction of the Skin. .
22. On Spontaneous Lassitude.
23. The Diet of old Men.
24. For Rugosity of the Body.
25. To make the Perspiration fragrant.
6
26. To Warm the Habit.
27. For Paleness.
28. On Lividity.
29. Preservatives of the Teeth.
30. To prevent Dullness of Hearing.
31. On Dimness of Sight.
32. On Repletion.
33. On Intoxication.
34. On Corruption of the Food, or Dyspepsia.
35. On Venery.
3(5. On Impotence.
37. On Inordinate Venery.
38. On Redundance of Semen.
39. On Congelation.
40. On Sun- burning.
41. On collections of Phlegm in the Stomach.
42. How to produce easy Vomiting.
43. On Laxatives and Diuretics to those who are in Health.
44. On Clysters.
45. On Suppositories.
46. On Medicines which evacuate the Head — on Masticatories, Errhines,
and Liniments to the Nose.
47. On Emmenagogues.
48. On Sudorifics.
49. On Airs.
50. On Waters.
51. On Baths.
52. On the natural Baths.
53. On the Regimen fitting to the different Seasons.
54. On the Regimen of Persons in Business. 'm
55. On the Regimen of Travellers.
56. On the Regimen of Persons at Sea.
57. On diminishing Obesity.
58. How to recruit those who are Emaciated.
59. How to recruit parts which are Emaciated.
60. How to know the best Temperament.
61. How to know the Intemperaments of the Body.
62. On the Form of the Head.
63. How to know the Temperaments of the Brain.
64. How to know the Temperaments of the Stomach.
65. On the Temperaments of the Lungs.
66. On the Temperaments of the Heart.
67. On the Temperaments of the Liver.
68. On the Temperaments of the Testicles.
69. On the parts that are omitted.
TO. On tlie Cure of (he Hot IiileLuperameiLls <rf ibe Body.
71. On the Cure of die Cold [iitemper:im;nts of ihe Body.
73. On tlie Cure of ihe Dry Tutenipcramenls, as of the Stomach, for <
xmple. Then of ihe other In temperaments.
73. On the Powers of the Articles of Food.
74. On Pot.Herbs.
75. On Asparagi, or Young Slioots.
76. On Escotent Roots.
77. On Tiuffles and Moshrooms
78. On different kinds of Com,
79. On Pulae.
80. On the Fugacious or Summer Fruits.
ei. On the Fruit of Trees.
82. On Animals; and, Srst, of Fowls.
B3. On Eggs.
84. On Beasts.
85. On the parts of Animals.
86. On the Milk and filood of Beasts.
87. On the Dnnking of Milk.
88. On Milk that has been separated into part^i.
8Ih On Cheese.
■ 90. On Fish.
91. On the Crjstacea.
OS. On theMollusca.
03. On (he Cartilaginous Fishes.
04. On tbe Cetaceous Fishes.
95. On the Properties of Wine.
96. On Honey, and honied Water or Mead.
97. On Sleep.
98. On Watcbfulnefs.
99. On Somnolency.
100. Diocles' Epistle on the Preservation of Health.
PAULUS iEGINETA.
BOOK FIRST.
I. — On the Complaints of Pregnant TVomen and their Diet.
Of the complaints which hefal women in a pregnant state, since
the most trouhlesome are a redandance of crudities, continued vo-
miting, salivation, pain at the cordiac orifice of the stomach, and
loathing of food ; it will not be improper to give directions regard-
ing them. The most suitable remedies are, exercise on foot, food not
too sweet, wines which are yellow, fragrant, and about five years old,
and moderate drink. All these things are proper for the cure of cru-
dities and vomiting. For medicines, you may give the bloodwort,
boiled in water, for drink ; and likewise dill, and the Pontic-root,
called Rha, in the dialect of that country. These things may be
taken at the time of eating, or before it. Externally, the flowers of the
wild vine, those of the wild or domestic pomeg^nate, the leaves of
the alsanders (smymium), and the seed of the fennel, may be mixed
together along with dates and old wine, and applied to the prsecor-
dium in the form of a cataplasm. Pains at the orifice of the stomach,
may be alleviated by drinking warm water, by gentle exercise on
foot, and by covering the hypochondrium with soft wool. To those
who have an aversion to food, you should recommend a variety of
articles of a savoury nature, and also dry starch. This last is par-
ticularly applicable to those who long to eat earth, as is the case in
the complaint called pica, which occurs most frequently about the
third month after conception ; because the foetus being then weak,
cannot consume all the aliment which is brought to the uterus, and
hence the superfluities are collected in the stomach. Wherefore, they
have a desire for complicated and improper articles, such as burnt coals,
Ciraolian earth, and various such things. On that account, the af-
fection has got its appellation, either from the variety of colours
which the bird pica possesses, or from its being subject to this com-
8 • PAULUS yliGINETA.
plaint. Labour and long journeys will also contribute to restore a
desire for wholesome food. But she who has accustomed herself to
live in an indolent manner, will not be able, when she proves with
child, to bear exercise all at once. To those who loathe food, it
may be of service to take acrid substances, and particularly mustard.
For swellings of the feet, it may be proper to bind over them the
herb anthyllis, soaked in vinegar ; or to lay the leaves of a cabbage
over them, and to anoint them with Cimolian earth mixed with vine-
gar, or with alum and vinegar. It is likewise of use to wash the
feet with a decoction of the Median apples, called citrons.
II. — On the Nurse,
A NURSE is to be chosen who is free from every complaint, and is
neither very old nor very young. She ought not to be less than
than twenty-five, nor more than thirty-five. Her chest should be
large, as also her breasts, and her nipples neither too prominent nor
too much retracted. Her body should be neither very fat nor very
spare. It is of great consequence to the child that his nurse should
have brought forth not long before, and that her child had been a
male. She ought to avoid every thing of a very desiccative nature,
and likewise such as are saltish, acrid, sour, acid, bitter, very heat-
ing or of an offensive smell ; also, such as are strongly fragrant,
cx)udiments, and such like acrid substances. Let the nurse also ab-
stain from venery. Let her work with her hands and shoulders,
let her labour at the mill and the loom, and carry about the child
in her arms. This may be done even when it is three or four months
old.
III. — On the Milk of the Nurse.
The best milk is that which is moderate in thickness, quantity,
colour, smell, and taste. It is a proper way to try the quality of the
milk, by pouring a little of it upon the nail of the thumb and ob-
serving it in the sun ; for, when upon turning the nail, it neither
runs off too slowly nor too quickly, it is good milk. You may also
try it thus, by pouring some milk into a glass vessel, and putting
some runnet into it, then stirring it about with your fingers, allow
it to coagulate, and observe whether the cheesy part be less than
the serous : for such milk is not good, and also the opposite
kind is of difficult digestion. The best kind is that which has a
moderate proportion of each.
IV. — How to correct the bad qualities of Milk,
Thb bad qualities of milk may be thus corrected. If it be too
thick, the phlegm ought to be evacuated by vomits, the most pro-
BOOK FIRST. 9
per of which, are those of vinegar and honey. It is also proper to
extenuate by labour before eating. Also, the following substances
may be given : — namely, wild marjoram, hyssop, savoury, shep-
herd's needle, thyme, a little radish, and old pickle with vinegar
and honey. But if it be more acrid and thinner than natural, the
nurse ought to be relieved from labour, to be fed upon strong soups,
and the flesh of swine, and drink sodden must and sweet wine. If
it be in too small quantity, she ought to get soups and a generous
diet, with sweet wine for drink. And let her breasts and nipples
be rubbed. The cupping- instrument, if applied, will also be of ser-
vice. That medicines for the formation of milk, are possessed of
some efficacy. I am well aware, and yet I do not recommend them
in all cases, for they speedily waste the body. They are the root
and fruit of the fennel boiled in ptisan, the leaves of the citisus in
dark-coloured wine or ptisan, the sweet gith (melanthium) , dill,
the root and fruit of the carrot. They are to be first soaked with
warm water, and then given. But when the milk is bad, whether it
be thick, acrid, or of a strong smell, it is first to be sucked out, and
then the child is to be applied. Por that which is acrid, ought on no
account to be given to the infant when hungry ; but that which has an
ofiensive smell, may be corrected by fragrant wine and sweet food.
Of coagulated milk in the breasts, we will treat in the Third Book.
V. — On the Nurture of the Infant.
The first food given to a new-born child should be honey, and after-
wards milk, twice, or at most, three times a-day. When it appears
disposed for it, and seems able to digest it, it may get some food, care
being taken not to stuff it. If this should happen to be the case, it
will become more sleepy and inactive, there will be swelling of the
belly and flatulence, and its urine will be more watery than natural.
When this is observed, it ought to get no more food until what it has
got be consumed. The child may be brought up upon milk until it
be two years old, after which, its diet may be changed to food from
grain.
VI. — On the Eruptions which happen to Children.
Whatever eruptions appear upon the skin of a child, are to be
considered, in the first place, as a good indication ; but when the
eruption is properly come out, it may be cured, by putting the child
into baths of myrtle, or lentisk, or roses, and then anointing with the
oil of roses or lentisk, or with a cerate containing ceruse. And its
body may be gently rubbed with nitre, but it will not bear hard
friction. But the best plan of cure, is for the nurse to live upon
f-weetish things. And the child's diet ought to be attended to, so
that it be neither too full nor too spare. If the child's belly be consti-
pated, a little honey may be put into its food ; and if even then it do not
10 PAUL.US JiGlNETA.
obevi turpentine, to the size of a chick-pea may be added. When
the belly is loose, millet in particular ought to be ?idministered.
VII. — On the Cough and Defltixion of Infants.
Whbn the child is seized with cough or defluxion, recourse is
to be had to a Linctus of honey. Its head is first to be bathed with
warm water, and plenty of honey given ; then press its tongue
gently with your finger, and it will vomit up much phlegm.
VIII. — On Pruritus of the Skin,
If the child be seized with pruritus, use fomentations, and anoint
him with plenty of boiled oil, in which a little wax has been melted.
IX. — On Dentition.
The teeth begin to g^ow about the seventh month. At that
time inflammations of the gums, cheeks, and tendons are apt to
occur ; and sometimes convulsions. The child must then get no-
thing which requires mastication; and you should rub his gums
frequently when in the bath with your finger, or soften them with
the fat of fowls or the brain of a hare. When the teeth are just
coming through, you may wrap the neck, jaws, and head in soft
wool, or they may be anointed with warm sweet oil, some of which
ought to be poured into the pores of the ears. The child ought then
to have a more generous quality of food, and be bathed in warm water.
If he have diarrhoea, you must try to bind his belly by epithemes,
or external applications of an astringent nature, such as cumin, dill,
or parsley, sprinkled upon wool. It is proper to mix the seeds of
roses, and, in short, to use all d^siccants. If the bowels are consti-
pated, they may be gently roused to action by means of a suppository
of honey, or the belly may be rubbed with mint mixed up with honey.
But the best remedy for the convulsions of children, is to bathe
them in water wherein tumsol (heliotropium) has been infused. It
will be of consequence also to use the oil of privet, of the iris, and
the Secyonian oil ; and, in short, every thing which is of a calefa-
cient nature. But when the teeth have come through so as to bite
the fingers, it may be proper that he keep in his mouth the root of
the iris, shaven down and not quite dried. This also is of use to
ulcers. Butter likewise rubbed in with honey will be of service.
The flesh of an old pickle will relieve pruritus of the gums.
X. — On Aphtha.
Infants are liable to an ulcer of the mouth called aphtha. It is
either whitish, reddish, or black, like an eschar. That which is
BOOK FIRST. II
black is of the worst kind and threatens death. The iris mixed
with honey is of use, or you may blow in the dry powder if you
please : also, the pounded leaves of roses* or the flowers of roses,
and crocus — ^a smtdl quantity of myrrh, g^s, frankincense, or the
bark of the frankincense tree, all these together, or separately, may
be mixed with honey; and, in addition to these, may be joined
honied water, and the juice of the sweet pomegranate.
XI. — On Esccortations of the Thighs,
Excoriations of the thighs may be sprinkled with dried myrtle,
cyperus, and roses.
XII. — On Watery Dischargee from the Ears.
Watbrt discharges frcHn the ears may be dried up by applying
to them wool with alum, or with wine and honey, or by an injection
of old wine either alone or mixed with saflron.
XIII. — On Siriasis,
SiRiAsis is an inflammation oi the parts about the brain and its
membranes. A hollowness of the open of the head and eyes attend
it, with paleness and dryness of the body. It is relieved by an
application of the red of an egg with oil of roaes to the open of the
head in the form of a compress, and frequently changed.
. Another appHaUion for Siriasis. — Place upon the open of the
head, the leaves of that species of heliotropium called scorpiums,
the parings of a gourd, the memlnrane which envelopes the fleshy
part of a pompicm, the juice of the garden night-shade, with oil of
roses.
XIV. — 7%c Regimen of Infancy^ and the succeeding ages
until manhood.
Infants and children when weaned from milk, are to be allowed
to live marily and without restraint ; their food ought to be light,
aad their exercise gentle. After six or seven years of age, both
boys and girls are to be consigned over to writing-masters of a
mild and benevolent disposition ; as such persons will impart in-
struction to them in a cheerful manner, and without constraint ; for,
relaxation of the mind contributes much to the growth of the body.
Boys of ten years of age must go to teachers of grammar and geo-
metry, and harden their bodies by gymnastic exercises. From
fourteen to twenty- one, their proper employment will be the study
of mathematics and instruction in philosophy. At the same time.
12 TAULUS ^GINETA.
however, it will be proper to use more exercise for strengthening the
body, so that being accustomed to labour, both with mind and body,
they may be prevented from indulging their carnal desires. They
ought likewise to be restricted as to wine. To those who are in man-
hood's prime, the fullest supply of nurture, both to body and mind,
ought to be allowed ; wherefore, they should use all kinds of gym-
nastic exercises, particularly such as each has been accustomed to,
and food which is fitting and nutritious. In the decline of life, both
the bodily and mental supply ought to be abridged ; and the gym-
nastic exercises diminished in proportion. The food also is to be
gradually lessened as the habit begins to contract the frigidity of
age.
XV. — On the Preparatory Friction.
Before gymnastic exercises, the body ought to be rubbed mo-
derately first with towels, and then with oil in the hollows of the
naked hands, tmtil the body be properly warmed and softened. Its
surface ought to have contracted a florid blush, and its vessels to
be distended.
XVI. — On Exercises.
Exercise is a violent motion. The limit to its violence should
be a hurried respiration. Ehcercise renders the organs of the body
less liable to sustain injury, and fitter for their functional actions.
It makes the absorption of food stronger, and expedites its assimi-
lation ; for it improves nutrition by increasing heat. It also clears
the pores of the skin, and evacuates superfluities by the increased
motion of the lungs. Since, therefore, it contributes to distribu-
tion, care ought to be taken, that neither the stomach nor bowels
be loaded with crude and indigestible food or liquids ; for there is
a danger lest they should be carried to all parts of the body before
they are properly digested. It is clear then that exercise ought to
be taken before eating. The colour of the urine will point out the
proper time for exercise. When it is watery, it indicates that the
chyme absorbed from the stomach is still undigested. When it is
of a dark yellow colour, and bilious, it shows that digestion had
been long ago accomplished. When it is moderately pale, it indi-
cates that digestion has just taken place, and this is the proper time
for exercise, after having evacuated whatever excrementitious mat-
ters are collected in the bladder and bowels.
XVII. — On the kinds of Ea^ercise.
This is the common effect of all kinds of exercise, that they increase
the natural heat of animals ; but each species has something peculiar
to it. Strong, that is to say, violent exercise rouses the tone of the
muscles and nerves. Such are digging, and lifting a heavy bur-
BOOK FIRST. 13 ^
•
den, while one remains in the same spot, or moves a little ; or lift-
ing small weights and walking ahout as much as one can. Of this
kind, is the exercise of scaling a rope, and many such. The swift
kinds of exercise are such as do not require strength and violence,
namely — running, fighting with one's shadow, wrestling with the
extremities of the hands, the exercise with a leather-hag, and that
with the small hall. This last is compounded of strength and ve-
locity ; and such exercises as are strong, may become intense by add-
ing velocity to them. Besides, some kinds of exercise bring the
loins into action, and some the hands or legs ; others the spine or
the chest alone, or the lungs. And exercise ought to be carried on
until the vessels become distended, and the skin of a fiorid hue ; and,
until then, the motions ought to be strong, equable, and unremit-
ting. Upon this you may see warm sweat, mixed with vapour,
break out. It will then be time for you to stop, when any of the symp-
toms which I have mentioned have undergone a change, namely,
when the bulk of the body becomes contracted, or when the florid
colour of the skin declines. And, should any of the motions remit,
it will then be time to stop ; or, if there should be any change in
the quantity or quality of the perspiration ; for, if it should become
smaller in quantity, or colder, we must desist, and besmearing the
body with oil, endeavour to restore it. It will then be proper to
use the Restorative friction as the masters of gymnastics practise.
XVIII. — On the kinds of Friction.
Hard friction contracts, and soft relaxes ; so that those parts of
the body which are relaxed should be rubbed hard, and those which
are contracted softly. When the body is neither in the one state
nor the other, it is clear that neither the one mode of friction nor
the other should be had recourse to, but as much as possible either
extreme ought to be avoided. Much and hard friction diminishes
the bulk of the body, whilst, on the other hand, little and soft distends
it. If the three different kinds of frictions as to quantity be joined
to the same number as to quality, they will produce nine combina-
tions, as is stated below. For one of the kinds, as to quantity, for
example, much, being complicated with the three differences as to
quality, I mean the hard, the soft and the moderate as to hardness,
will produce three combinations ; and, again, the little being joined
to the other three, will produce three more ; and the moderate as to
quality being complicated with the same three, will produce more,
as is shown below : —
QUANTITY. QUALITY.
llittie^^^.^^-.^^^^-^^^w f "I >^^ r- ^HOrd.
Little,«s^s«««,«s^s.rs^^^>,..s,< and >,«s...>«vr<«vrwrv^,^><^^>^Soft.
Moderate -^^^v^^r^-r.-. r "I -rv^s^^^^^-v^v^^^N^Hard.
Moderate .^^^^.*s^s^< and \.r.r.^.r.^ ^..^^Soft.
Moderate ^^v^,^-rwr^ L J ^^^^^.^.r^^^ -^Moderate.
14 PAULUS iEGINETA.
XIX. — On Vociferation, or the Exercise of the Voice,
I^ the exercise of the voice, regular and gentle modulation con-
tributes nothing to health, but the utterance of louder tones is be-
neficial, and is therefore to be practised. For much air being
inhaled by respiration expands the chest and stomach, and dilates
and extends all the pores of the body. Wherefore, even in reading,
it promotes the excretion of redundiant humours, to those who read
in a high tone, by inducing sweats ; while in those who read with
a moderate tone it promotes the insensible perspiration over the whole
frame. It also promotes health by attenuating the excrementitious
matters which are hawked up ; the saliva, mucus, and phlegm being
discharged and consumed in this way. And to those who stand in
need of warming, owing to frigidity, what mode of relief can be more
proper than the action of respiration } Such persons ought therefore
to read frequently, and relaxing the whole body, so as to distend the
wind-pipe, and all the other passages of air, endeavour to utter the
loudest soimds. And yet we must not have recourse to the exercise
of the voice rashly, and without consideration, nor when the system
is filled with depraved humours, or the stomach loaded with crudi-
ties, lest noxious vapours be thereby distributed over the whole body.
XX. — On Lassitude from Exercises,
That species of lassitude called the Ulcerose is occasioned by a
collection of thin and pungent superfiuities in the body. In the Ten-
sive there is scarcely any superfluity in the system, but the state of
the muscles and nerves is such that they appear to be stretched. The
Inflammative, in which we feel as if the parts of the body were
bruised or inflamed, happens when, being heated, the muscles at-
tract the surrounding superfluities. There is a fourth species oc-
casioned by an unnatural dryness of the muscles, in which the body
when naked appears squalid and constricted, and is averse to motion.
The cure of the ulcerose species consists in dispelling the superfluities
by much and soft friction with plenty of oil that contains no astringen-
cy. The indication of cure in the second or Tensive species is relaxa«
tion, which may be accomplished by means of little and soft friction
with oil heated in the sun ; by quietude and rest, by tepid baths, and
remaining for c( considerable time in the warm water ; for, if you
repeat the bath two or three times in succession, you will confer so
much the greater benefit. In the third species, or the Inflammative,
there are three indications of cure, the discharge of the superfluity,
the relaxation of the constricted parts, and the cooling of the inflam-
matory state. Plenty of tepid oil, the softest friction, and remain-
ing long in a bath of a moderate temperature, remove lassitudes of
this description. Long continued quietude is also proper, and re-
peated inunction. The treatment of the fourth diflfersin no respect,
for the first day, from that of the third, except that the water ought
BOOK FIRST. 13
to be hotter, so as to contract gently. On the second, the Restora-
tive kind of exercise must be had recourse to; and when in the bath,
let the person straightway leap into the cisterns of cold water. All
those affected with lassitude stand in need of wholesome food.
XXI. — On Constriction of the Skin.
Constriction is occasioned either by obstruction or contraction
of the pores. Obstruction is produced either by the quantity or
thickness of crude and indigested humours, and contraction either by
cold, astringent, or desiccative substances. Upon stripping the body
the affection is at once recognized, by the paleness, hardness, and
contraction of the skin, and by the body's being heated with diffi-
culty during exercise. Cale£Eu;ient remedies are the proper cure for
this state of body, and therefore we must have recourse to the
strongest exercise and the hottest baths, and the time of remaining
in the cold bath must not be long, nor must the water be very cold.
And when about to put on their clothes, let their bodies be anointed
with a sweet and thin oil, of a moderately heating quality. Ob-
structions of the skin are also properly cured by the oil of dill,
(more particularly if the dill had been green,) and by the oil of black
poplars.
XXII. — On SponianeotAS Lassitude.
SiNCB the ulcerose lassitude is occasioned by the ill digestion of
acrid superfluities, if the cacochymy be small, the restorative exer-
cise will be sufficient ; but if it be greater and deeper-seated, we
must not permit such a one either to exercise or to take any motion
whatever, but he must for one day remain without food, in a state
of quietude and sleep ; and then in the evening, when he has been
rubbed with emollient unguents, and bathed in tepid water, we must
give him wholesome food and some soup. And we must also not
restrict him from wine; for nothing contributes so much to the di-
gestion of half-digested humours as wine. Should the symptoms
be removed by means of the aforesaid treatment, we may allow the
man to return to his usual employments ; but if on the following
day they should still remain, we must bethinjc ourselves of a more
potent remedy. If his strength be good, we must have recourse
either to phlebotomy or purging, having first determined which of
these remedies we shall try. If he be weak, we must not bleed,
but may purge him moderately. If there be many crude humours
in the system, we must neither bleed, nor purge, nor exercise, nor
move at all, nor tiy the bath, but we must keep him in a state of per-
fect quietude, and give him food, drink, and medicines of attenuating
and incisive qualities, without being of a manifestly heating nature.
We may give him vinegar and honey, and occasionally some ptisan
or honied water. And since, in such persons, the hypochondrium is
16 PAULUS ^GIXETA.
apt to become swelled and distended with wind, and whatever food
is taken to be converted into flatulence, it will be better to give
some pepper along with the food. It will be better too to use the
composition called Diospoliticus, and that Simple Medicine which
consists of three kinds of peppers. Oxymel is also most pro-
per. We may likewise use a drink made from honey, particu-
larly when it begins to become acid ; and such wines as are gently
acid, and such articles of food as are attenuant without being heat-
ing, as capers, if taken with vinegar and honey, or vinegar and oil.
When the tensive species of lassitude takes place without exercise,
it indicates that a plethora distends the solid parts of the body.
If the fulness be occasioned by blood, it will be best to open a vein,
or scarify the ancles. If the inflammative lassitude be spontaneous,
it will not endure a delay of a few hours, much less of two or three
days, for it straightway induces a strong fever, unless one anticipate
by letting blood. It will be best, if possible, to abstract blood
twice in one day ; for if care be taken that the first bleeding do
not occasion swooning, it will be of less consequence whether or not
it occur after the next. Those who are not bled will be fortunate
indeed if they escape with the life.
XXIII. — On the Regimen of Old Persons,
Old age is dry and cold ; and its correctives are calefacients and
diluents compounded with them. Friction is to be applied to the aged,
but so as not to occasion lassitude. To such as are weak, some such
course of diet as the following is to be prescribed : — About the third
hour, a small bit of bread with Attic honey; and afterwards, about the
seventh hour, after having undergone friction, and taken exercise and
baths suitable to old men, they must first get such things as are of a
laxative nature, and afterwardsfish or fowls; and then for supper, such
things as are wholesome, and not apt to spoil in the stomach. I also
do not forbid them to use wines prepared with honey, particularly such
persons as are suspected of being threatened with the stone or gout,
and in that case, a little parsley may be added. If phlegm be gen-
dered in the stomach, we must of necessity apply such remedies as
will remove it, and return immediately to a diluent diet : We must
give them ripe figs in preference to every other kind of food, and if
during the winter, dried figs, unless they complain of unpleasant
sjonptoms in the right hypochondrium. When serous and pituitous
recrements collect in the bodies of old men, we must promote the
discharge of urine every day, and soften the belly, principally by giv-
ing oil before a diet. It is obvious, that all pot herbs ought to be
eaten before all other food, with oil, pickles, or olives and dama-
scenes seasoned with salt. When the belly is bound, the herb
mercury, and the bastard saflPron, will relieve it. Turpentine also is
proper in such cases. It may be given sometimes to the bulk of a
Pontic walnut, and sometimes of two or three. Oil also in a clyster
is most useful to those who are constipated.
BOOK FIRST. 17
XXIV.— For Rugosity of the Body.
RaaosiTT of the body may be removed, by the farina of bitter
tares, mixed with white vine.
Another abstergent composition (smegma), to be constantly rab-
bed upon the skin : — ^Fat figs braised with bryony, and the burned
powder of tares, the shells of the cuttle-fish (sepia), mixed with a
small quantity of honey.
XXV. — To make the Perspiration fragrant^
Thb perspiration may be rendered fragrant, by mixing the leaves
of the cypress, pounded dry, and the bu-k of the pine in the same
ointment. One ought also to remember in the morning, immedi-
ately after being db-essed, to taste a small quantity of cassia or
savin.
XXVI.— Tb warm the Haint.
SiNCB even the habit must be warmed, it will be proper to use a
preparation of a heating nature when in the bath. Let it contain
calamint, maijoram (sampsuchum), hyssop, bay berries, rosemary,
the stone p3rrites, salts, the burnt lees of wine, nitre, pumice stone,
each in proper proportion ; also, a smaU quantity of mustard, staves-
acre, and the seeds of the thymekea (granum cnidium). After the
bath, use a warm restorative (Acopmn), and drink a yellow old wine,
having previously taken a draught ftom wine and honey, pepper,
me, and the like.
XXVIL— For Paleness.
Palbnbss of the body is diminished by a merry course of life,
and grateftd food, by mixing together radishes, leeks, and the green
chick-pea. Taking the juice of the sweet pomegranate restores
the complexion. (Ml, in which the root of the white vine (bryonia),
has been long boiled, is likewise proper. This gives tone to the
body. For detergent applications, mix some agghitinants with
detergents, as farina, the bulb of the narcissus, and the root of the
bryony. The root also of the bitter almond, if taken in abundance
wUl improve the colour, and likewise the fruit boiled in water
Qsod for a bath.
XXVIIL— 0» Uvidity.
Livid spots are prevented from forming on old men, by render-
ing, their skin thick and hardy, and by warming the habit. In
0
18 PAULUS ^QINETA.
order to dispel them, the black places should be rubbed in the bath
with salts, and fomented with sponges steeped in a decoction of rad-
ish or wormwood.
XXlX.-^Preservatives of the Teeth.
Thb teeth will not decay if the following things be attended to :
In the first place, to avoid indigestion, and frequent repetitions of
emetics. Guard against such food as is hurtful to the teeth, as
dried figs, honey boiled, so as to become very hard, dates which
are difficult to rub down, and all glutinous substances ; likewise
such things as are difficult to break, and may thereby loosen the
teeth ; in like manner also, such substances as set the teeth on edge,
and every thing ^which is cold and putrid. The teeth also ought to
be cleaned after supper.
XXX. — For dulness of Hearing.
DuLNESS of hearing may be prevented by clearing away the sordes
from the meatus, and by occasionally introducing into the ear
a piece of linen dipped in a calefacient ointment (dropax), pressing
it down, and then drawing it out ; for this completely clears the
opening, and, at the same time, stimulates the sense of hearing.
Afterwards, the meatus is to be plugged up with a piece of wool of
the size of a tare for a day ; and, when it is taken out, the meatus
is to be anointed with the oil of almonds, of spikenard, or of chamo-
mile, with the fat of geese, or a small quantity of ox gall. Again,
after a time, rubbing mustard and figs together, introduce this col-
lyrium for two hours ; and, when it is taken out, pour in oil heated
in the hollow of the root of the asphodel.
XXXI. — On dimness of Sight.
In order to avoid dimness of sight, when they plunge into cold
water people ought to open their eyes wide, for thereby the strength
of their eyes will be much improved. They ought also tp be care-
ful not to hurt them by reading. Let them also avoid wine that is
thick and sweet, such articles of food as ascend upwards, whatever
is of difficult digestion, and engenders stagnant and thick humours,
the herb rocket, leeks, and every thing whose pungency ascends to
the head. Let them also avoid reclining long in a supine position,
cold, winds blowing direct in the face, smoke, and dust ; and pour
daily into the eyes an infusion prepared thus : For a month and a
day, put green fennels into an earthen vessel smeared with pitch on
the outside, and pour in rain water, and then taking out the fen-
nels, keep the water laid up for use.
BOOK FIRST. 19
XXXII. — On Repkiian.
£xcx88 in diet is a very great error ; for, even if the stomach
^uld digest it properly, ^e veins, being too much filled, labour,
are distended, burst, become obstructed, or are swelled up with
vapours, and become much oppressed. In diseases, nothing is
worse than plethora of the veins ; for, in plethora of the stomach,
the offisnding matters may be evacuated either upwards or down-
wards, so that it is less pernicious than the other, and yet it is by
no means desirable ; but, if there be too much food in the stomach,
it must be immediately evacuated by vomiting, for there is a danger
lest being digested it fill up the veins, more particularly if the per-
son who is g^ty of the excess be not attentive to the necessary eva-
caations. Let him vomit, then, before the food become corrupted ;
or, if there be any objection to vomiting, it will be of great conse-
quence to bring about frequent discharges ftrom the belly ; or other-
wise, he should indulge much in sleep, and drink often of tepid
water. When he has digested properly, and more especially if he
has had evacuations by ti^e bowels, let him have baths and fomen-
tations, and let him drink moderately of watery draughts, and eat
Bome pickle. But should )ie neither have alvine evacuations, nor
digest readily, and if his whole body be heavy, averse to motion,
and sleepy, and if his mind be oppressed with unusual sluggishness,
these sjrmptoms indicate plethora of the veins ; and, when lassitude
snp^venes to these, it will be proper to enjoin quietude until diges-
tion in the stomach be accomplished, and then evacuate by labour.
XXXIII. — On Initmcatwn.
To those who are intoxicated, vomiting is an immediate relief.
It will be proper that they drink freely of water and honied water,
so that they may vomit freely, and remove the uneasy feelings.
After vomiting, let them use the bath, along with plenteous unc-
tion, and afterwards rest for some time, well covered up, until they
have slept off their debauch.
XXXIV — On wronff digestion of the Food.
It contributes much to the health of those whose food spoils in
tlieir stomachs, that the ofiending matters be discharged down-
wards ; and when they are not so discharged naturally, this opera-
tion ought to be promoted by gentle laxatives. Such persons be-
fore a meal may, with advantage, take an emetic of wine, or
must. They ought also to be counseUed not to take food of a
itrong or offensive smell, nor such as easily becomes spoiled ; but, on
tiie contrary, such as is wholesome. To such persons, evacuations of
tile bowels at proper intervals, by means of gentle laxatives, are
lagkly expedient.
c2
20 PAULUS iEGINETA.
XXXV.— O/i Venery.
From sexual enjoyments, the following advantages may be de-
rived : they relieve plethora, render the body lighter, promote its
growth, and make it more masculine ; they free the mind from the
cares which beset it, and dispel ungovernable anger. Wherefore,
the best possible remedy for melancholy is coition. Those also who
are otherwise affected with mania it will restore to reason. It is also
a powerful remedy for phlegmatic disorders, will restore the appe-
tite to those who want it, and dispel continued libidinous dreams.
The habits which are most adapted for venery are the hot and hu-
mid, and these bear it best. A dry and cooling diet, old age, and
the season of autumn unfit for it. The diet, therefore, ought to be
humid and heating ; and moderation as to labour and food ought to
be observed. And as other kinds of labour are of use, so also are the
venereal, when taken in moderation ; for they incite to the act, and by
habit, induce facility of performing it. But nothing is so much required
as abundance of food, which also ought to be of a nutritious nature.
Of fishes, the best are polypi, (which are otherwise supposed to in*
cite,) and all the class called mollusca ; of pot-herbs, the all-good
(horminum), hedge-mustard (erysiraumX, rocket (irio), and turnip.
And the following are similar medicines : — of pulse, beans, chick-
peas, tares, gallic beans and pease, which fill the body with vapours
and abundance of food. Rue, as it concocts and dispels flatulence^
blunts the venereal appetite. * But I greatly approve of grapes,
which supply the body with moisture, and fill the blood with flatus,
which rouses to venery. He who is about to proceed to the act
ought to avoid repletion, indigestion, lassitude, precursory. vomits
and purges, and, in like manner, a sudden diarrhoea ; for a chronic
one is sometimes cured by venery. And strong desires I do not ap-
prove of, but think that they ought to be contended against> especi-
ally by those who have any distemper. The most proper season for
enjoyment is after gymnastic exercises, baths, and a moderate re-
past ; for food contributes to the strength, and diminishes the chills
which succeed it. The most proper time, as I said before, is after
eating, and before sleep, for the lassitude is relieved by sleep. This
too is the fittest time for procreation on many accounts, and because
that the woman falling asleep is the more likely to retain the semen.
XXXVI. — On Impotence.
In cases of impotence, it may be proper to rub the parts frequently
with an ointment containing a small part of the root of the narcis-
sus, or the seed of the thymelaea, or pellitory, or stavesacre, or the
seed of the nettle, or of anise. Let him also beforehand take a drink
with pepper, or satyrium, or rocket, or bastard saflron, or all together.
Before food, let him also eat the small red bulbi roasted, with salt
and oil, or a little of the squill dried in the sun. He may also use
BOOK F1A8T« 21.
the compound preparations elsewhere described, and often indulge
in obscene reading.
XXXVII. — On inordinate Venery,
Since by too much indulgence the body becomes flabby, cold,
dried, and weak, it must be supplied with such things as will
brace, warm, humectate, and strengthen it. To those who in-
dulge themselves immoderately, warm clothing is suitable, also rest
and sufficient sleep until the body remits from its contraction, and
they recover from their atony.
XXXVIII. — On redundance of Semen.
SoMB persons collect much semen of a warm nature, and then
proceeding to coition and discharging it, render the body weak,
occasion resolution of the stomach, and so become emaciated and
dry : or» if they abstain from venery, they are seized with heaviness
of the head and anxiety ; after which, they have libidinous dreams,
and the same thing tsikes place. They must therefore avoid those
things which engender semen, and take such kinds of food and
medicines as consume it. After the bath, they ought to have their
loins rubbed with the oil of roses, or that of apples, or of unripe
dives ; and it is better to make them thick by mixing a little wax
with them, and the juice of some cooling herb, such as the house-
leek, solaniim, the umbilicus veneris, or flea-wort. In summer,
these may be used, but at other seasons, salt, and the juice of the let-
tuce and linseed boiled in water, for it also furnishes a cooling chyme.
And a plate of lead applied to the loins will prevent libidinous
dreams^ and herbs of a cooling nature, as rue and the tender
tops of the chaste-tree, if strewed under one in bed, will have the
tome effect. For this purpose, also, the seed of the chaste-tree and
of rue may be eaten* Care, however, must be taken that the loins
be not too mudi cooled, lest the kidneys be hurt.
XXXrX. — On concealed Persons.
Those who are much congealed ought to be laid in a warm place,
and rubbed with the oil of privet or of the iris. Afterwards,
when moderately heated, they should get pepper, or myrrh, with
sweet fragrant old wine, or cyrenaic juice in wine or vinegar, or
pelhtory or castor with vinegar, and take food of a warming nature.
XL.^—For Pe7*sons scorched by the Sun,
A PBRSON who has been scorched by the sun should be laid in an
airy place, and have his face, hands, and legs bathed with cold wa-
22 PAULUS ifiGINETA.
ter. If thirsty, he may drink cold water, if in the practice so to do ;
this, however, oaght to he done considerately, and not much at a
time. Let him also take some food of easy distribution, rather of a
humid than of a solid nature.
XLI. — On Collections of Phlegm in the Stomach.
If you should meet with a person who loaths any wholesome
food which is offered him, who abstains from food, or, if compelled
to take it, becomes sick, who longs after only such things as are
acrid, and has no pleasure even in them, but has his belly swelled
up with flatulence in consequence, is seized with nausea, and enjoys
only a short respite by eructations, and on whose stomach every thing
spoils and becomes acid, — ^know for certain that the remedies which
will afford him relief are such as will clear the stomach of phlegm.
I have known one of those so affected, after taking an emetic, con-
sisting of radishes out of ox3rmel, bring up an incr^ble quantity of
very thick phlegm, by which he has been straightway restored to
heaJth.
XLII. — How to produce easy Vomiting.
SiNCB to those who vomit with difficulty many disagreeable con-
sequences are apt to happen, it will be proper to explain by what
methods one may be made to vomit roidily. For this operation
evacuates phlegm and lightens the head, and prevents one from
being injured, although one had taken immoderately of indigestible
food and wine. Let the substances which are taken be neither sour
nor dry, but part of a sweetish and liquid nature, and part acrid.
Among these the radish is deserving of praise, and also the rocket,
and old pickle, green marjoram, and a small quantity of onion and
leek. Vomiting is likewise promoted by ptisans of poise, containing
some honey ; by porridge of bruised beans, and the lat of flesh ; but
one must not only take the juice, but swallow whole lumps of it.
And one must not spend much time upon mastication; but they ought
to be soft from boiling. It is clear, also, that it is the sweetish
kinds of wine which ought to be preferred, for such are aptest to
swim upon the stomach ; and tepid drink ought to be used. It is
necessary also to eat almonds dipped in honey, also sweet cakes,
and the moistened seed of the pompion and cucumber pounded with
honey. The root likewise of the cucumber rubbed with honey has
some effect. Those who wish to use more powerful medicines, mix
some wine with a decoction of the bulb of the narcissus. Vomiting
is also produced by the ointment of iris, if one will smear one's
fingers in it and tickle one's throat. It is also to be attended to in
vomiting not to intermit after vomiting is once begun, and to bathe
the face, and wash the mouth with sour wine or water, for this is
beneficial to the teeth, and relieves the head.
BOOK riasT.
XLIII. — On Laxaikfei and Diuretics to those in Health.
SoMB of the ancients thought it sufficient for health that the
bowels and urine should be evacuated once a-day freely and fully,
according to the quantity of food and drink which had been taken ;
and, -when the eracuations were agreeable to this rule, they were
satisfied, or, if otherwise, they endeavoured to correct them by
taking, in order to increase the urinary discharge, shepherd's needle,
parsley, asparagus, Macedonian parsley, anise, calamint, marjoram,
wormwood, the roots of grass and of golden thistle, tree-medic,
maiden-hair ; all these being boiled in water, so that the decoction
might be drunk with wine. For these things purify the blood by the
mine, and are of no small consequence. Alvine discharges they pro-
moted by giving turpentine to the quantity of an olive, when going to
rest, or, when they wished to purge more effectually, by adding a lit-
tie rhubarb. Soft eggs, of pot-herbs the beet and mallows, and the
wrap of shell-fish, are also laxative, and these probably will be suf-
ficient-; but, if more powerful remedies be required, the herb mer-
cury boiled in water with salt may be eaten, or the decoction drunk ;
and, in like manner, the leaves of the elder tree (sambuchus), or
the root of the oak-fern (polypodium), to the amount of two drams,
may be sprinkled upon pickle, or swallowed in a ptisan ; or milk-
whey, with salt ; or honey, to the amount of three or four hsemi*
nte ; or the btoth ol an old cock, by itself or with two drams of
bastard saffiK>B, or aloes, to the amount of about three chick-
peas, may be tkktn att supper-time. But the best remedy is dod-
def of thyme,- taken in wine after a moderate supper; but he
that wislM to puTj^ more strongly must take, in the morning, a
dram of this me^Mne infused in vinegar and honey, in the spring
season.
XLIV.— On Clysters.
In constipation of the bowels, when the stomach is so weak as not
to bear purgatives, we must have recourse to clysters. When phlegm
is contained in the intestines, the clyster may be composed of the
decoctions of dried figs, and of beet, nitre, the root of the wild
cucumber, honey, and the oil of chamomile or dill. But when the
complaint proceeds from dryness, they may be composed of those of
marsh-mallows, fenugreek, chamomile, oil, and a small quantity of
honey. And sometimes oil alone, injected to the amount of half a
hsemina, will produce the desired effect ; but even this must not be
repeated constantly, lest nature, by becoming accustomed to these
things, should forget to perform the evacuation spontaneously.
XLV. — On Suppositories.
Wb often use suppositories for the discharge of scybalse, or when
injections are not properly evacuated. Suppositories are formed of
24 PAULU8 iEGXNETA.
roasted salt, honey, and nitre ; or thyme may be mixed with boiled
honey. They are also formed of turpentine rosin, and nitre, and
sometimes with a moderate quantity of the seeds of the thymelsea
(granum cnidium). But it irritates the parts, which, therefore,
ought to be rubbed with oil. Pellitory and pepper are also added,
and are particularly fitted for paralytics, and for the relief of flatu-
lence from cold. Centaury also is mixed with pitch and cerate,
and is very applicable for paralysis of the genital organs* For in-
fants, a bit of thick salt is applied. Figs also are mixed up with
nitre.
XLVI. — On Medicines which evacuate Phlegm from the Heady
Maaticatories, Errhines and lAniments to the Nose.
Wb evacuate humows in the head with the saliva, by mixing a lit-
tle pepper with mastich, if a small discharge only be required ; or, if a
greater evacuation be wanted, by directing to chew pellitory or staves-
fskre. The root of every species of anemone, when chewed, also excites
the secretion of saliva, and the bark of the root of cappers. Serous
superfluities may be thus evacuated ; but, for thicker phlegm, we
must gargle with mustard in vinegar and honey, or with sodden
wine, having maijoram and hyssop boiled in it. I also mix this
with the gargle formed of mustard in vinegar and honey. When
we want to clear the brain of mucus, we must stimulate it by means
of acrid substances, of which kind some are sternutatories, llie juice
of either pimpernel, of the anemones, and of beet, purge by the nose.
The juice also of the leaves of the wild cucumber may be applied to the
nostrils, either alone or with the decoction or juice of the beet. But
sneezing is not at all applicable for crude humours contained in the
chest, lungs, and head. The following ointment may be rubbed
into the mouth : Anoint the roof of the mouth and uvula with a
soap containing the juice of the beet. The same application may
be used as an errhine. I have also often used the following com-
position, which is easily prepared : Macerate gith in strong vinegar
for a day, then next day rub it with the vinegar, and pour it into
the nose. Sometimes the gith may be rubbed with old oil ; and I
apply it in this manner. Archigenes used it in the same manner
for obstruction of tiie nostrils. Crito used the former cure, along
with vinegar, for jaundice.
XLVII. — On Emmenagogu^s.
All diuretics promote also the flow of the menses, such as the
decoction of the root of the cabbage, the root of the peach, rue,
marygold, dittany, and the seed of rocket. The same effect may be
produced by certain substances when applied to the mouth of the
womb, such as rue rubbed with honey, or the juice of leeks, or
finely-powdered germander (trisago), or myrrh, pounded in wine,
or the rennet of a hare.
BOOK FIB8T. 25
XLVIII.— On Sudorijics.
The following medicines are sudorifics: The dried powder of
chamomile, mixed with oil and rubbed upon the skin, seseli, pel-
litory, the seed of the rosemary ; anise, idso, when sprinkled upon
oil ; nitre toasted, and not very fine, with oil ; the flower of salt
mixed with oil ; cyrenaic juice dilated with water, which may be
nibbed into the body, and taken in a draught, to the amount of a
chick-pea. Calamint, in like manner, may be drank with honied
water, and rubbed externally with oil.
XLIX.— On Airs.
Thb best kind of air is that which is perfectly pure, such as that
which is not defiled with the exhalation from lakes or marshes, nor
from any pit which emits pestilential vapours. That also which is
impregiuited with the exhalations from a canal conveying the impa-
rities of a city is deleterious, and indeed every kind whidi is loaded
with vapours is not good ; as also that which is contained within
any hollow place shut up on all sides by high mountains, and not
admitting of ventilation. Those, therefore, which are thus deleteri-
ous, prove hurtful to all ages and temperaments, whereas the best
kinds agree with all ; but their difierences as to quality, I mean heat,
cold, dryness, and moisture, have not the same cdSect upon all.
Those of a proper temperament are benefited by temperate air,
whereas those lid>ouring under an intemperament derive benefit from
the opposite one.
L. — On Waters.
It is necessary also to be skilled in the good and bad proper-
ties of waters, for of all things water is of most use in every
mode of regimen. It is necessary to know that the best water
is devoid of quality as regards taste and smell, is most pleasant to
drink, and pure to the sight ; and when it passes through the prse-
cordia quickly, one cannot find a better drink. But such as remains
long there, and proves pungent to the stomach, which it swells up
with wind, and oppresses, is to be reckoned pernicious. Such wa-
ters are neither soon heated nor cooled, and tiiose things which are
boiled in them are slowly and improperly boiled. It is better there-
fore to prove such water by trial, which he who wishes may do by
attending to the following characters : — ^Those which run to thp
north and from the sun pass slowly through the stomach, and are
indigestible ; they are slowly heated and cooled. Those which arc
strained through any passage or soil to the east are soon cooled
and soon heated, and are to be supposed to be very good. Those
also are good which are colder in summer and warmer in winter.
26 PAULUS ifiOINSTA.
Some judge of waters by weight, counting that the best which
is lightest. This, if joined to the circumstances already mention-
ed, may be deserving of consideration, but is not of itself a suffi-
cient criterion of goodness. Rain water, as Hippocrates remarks,
is the lightest, the sweetest, the most limpid, and the thin-
nest, because that which is lightest and thinnest is attracted by the
snn, who draws snch particles to him, not only from all other wa-
ters, but also from the sea, and from bodies. Hence also it is the
most prone to putrefaction, as being composed of many different
qualities. Let no one suppose that the water which is most prone
to putrefaction is the worst, for susceptibility of change is rather a
good than a bad property ; so that if it has the other characteristics
of good water, and is prone to putrefaction, it is to be reckoned the
best possible. When beginning to turn it proves the cause of
hoarseness, coughs, and difficulty of speech, to those who drink it.
Of rain waters, that which falls in summer, and during thunder, is
preferable to that which fedls in stormy weather. That from ice and
snow is the worst, for during coagulation the finest particles of the
water are squeezed out. But waters which contain impurities, have
a fetid smell, or any bad quality, may be so improved by boiling as
to be fit to be drunk ; or, by mixing them with wine, adding the
astringent to that which is sweeter, and the other to the astringent.
Some kinds of water it may be expedient to strain, such as the
marshy, saltish, and bituminous. Those which are very cold are to
be drunk after food, and not in great quantity. Some also have
discovered certain articles of food and drink for correcting the bad
properties of waters. Hius, some beforehand drink of the decoction
of chick-peas, or eat them ; others, wild carrots boiled with some
small fish, and fennel in like manner ; whilst others again eat beet
and gourds beforehand with salt and diluted wine.
LI.— On Baths.
s
I THINK well of the cold bath, and yet I do not say that it is
proper for those who use no restriction as to diet, but only to those
who live correctly, and take the necessary exercise and food. It
tnay answer with most people very well, when they want to get
much cooled, to swim in water during the season of summer,
provided they are young and brawny, and have been previously
heated by friction. They ought to attend, however, that they be
not in a state of lassitude from venery or any other cause, nor suf-
fering from indigestion, nor after vomiting, nor after evacuation of
the bowels, nor when in want of sleep. It may be attended with
danger, if used at random. But the warm bath is the safest and
best, relieving lassitude, dispelling plethora, warming, soothing,
softening, removing flatulence wherever it fixes, producing sleep,
and inducing fulness of the body. It is expedient for all, man and
woman, young and old, rich and poor.
BOOK PIB8T. 27
LIL— On the Natural Baths.
Of natural baths, some are nitrous, some saline, some alaminoos,
some sulphureous, some bituminous, some copperish, some chaly-
beate, and some compounded of these. Of natural waters in gene-
ral, the power is, upon the whole, desiccant and calefacient ; and
they are peculiarly fitted for those of a humid and cold habit. The
nitrous and saltish are beneficial to the head, to defluxions of the
chest, to a watery stomach, to dropsies, to swelling after diseases^
and to collections of phlegm. The aluminous are fitted for spitting
of blood, vomiting from the stomach, immoderate menstrual dis-
charges of women, and repeated miscarriages. The sulphureous are
sootMng and warming to the nenres, and relieve lassitude, but weaken
and upset the stomach. The bituminous occasion fulness of the
head, and hurt the senses^ bat occasion a steady degree of heat and
soothe when persevered in« The oopperish ai« peculiarly adapted
for the mouth, tonsils, uvula, and eyes. The chalybeate are useful
to the stomach and spleen. The deeeent into the watar ought to be
without precipitation, in order that its impression may sink deep
into the body when relaxed.
lAlI.'-^On the regimen fitting to the di^ereni Seaeone.
It will be proper to regulate the diet with a view to the season.
In winter, take more fatigue, and eat more than usual, if the state
of the weather be northerly ; but if it be southerly, take the same
fatigue, but use less food sjui drink. In fine, make the body dry in
the wet season, and warm in the cold. Eat also warm fleshes and
acrid pot-herbs, and drink more wine than usual. In the beginning
of spring, either evacuate by emetics, or by laxatives, or get a vein
opened, according as habit or inclination directs'. Rest is suitable
to the season of summer, and also a diminution of labour and food ;
the food also ought to be more cooling, and the drink abundant \
and, in short, every thing ought to be done which can contribute to
cooling and dilution. In autumn, as it is a changeable, unsettled,
and unhealthy season, the diet ought to be particiidarly attended to,
that it be not too refrigerant ; moderation as to venery and cdid
drink ought to be observed ; and the cold breezes of morning, and
the heat of noon attentively guarded against. Too much fruit ought
likewise not to be taken, being hurtful not only by the quantity, but
also by the quality of the chyle which it supplies, and by engen-
dering flatulence. Nay, even tibe best kinds of fruit, figs and grapes,
occasion wind, unless taken before any other food, iot otherwise
they spoil the other food ; but if taken then, they neither occasioii
wind, nor spoil the other articles of food. When the air is cold,
the body must be warmed accordingly, and every thing done as in
the commencement of winter. It may also be expedient, after the
autumnal solstice, to have recourse to one of the afore- mentioned
28 PAULUS iEGINETA.
evacuations, lest any excrement! tious particles being shut up in the
system, should prove hurtful during the winter.
LIV. — Of the regimen of Persons in Business.
Hb who spends his time in business ought to consider, whether,
in tiie former period of life, he had been in the habit of taking exercise,
or whether, while yet taking exercise, he bears that habit well, and
escapes from diseases by having free perspiration. Such a state of
body is not to be suddenly changed to another habit, neither the
mode of those who have long been in ill health. But if his com-
plaints be protracted, and proceed from plethora, the indication of cure
ought to be by a healthful regimen, to supply moderate nourish-
ment ; or, if cacochymy was the cause, the indication will be to sup-
ply proper juices. Those who suffer from fulness are to be directed
when they go into the bath to use friction, and to take some exer-
dse, or, if accustomed to do so, to increase it a little, but to detract
from their food, and use less nutritious kinds than formerly ; but if
from collections of bad humours, one indication of cure is not suf-
ficient, because there is more than one kind of bad humours ; for,
some have a collection of cold and pituitous, some of hot and bilious,
and others of the melancholic. Every one, therefore, ought to
avoid those articles of food and drink which are apt to engender
that sort of humour which is collected. And in all these cases the
common remedy is purging of the belly.
LV. — On the regimen of Travellers.
In performing a journey, one will bear the fatigue best if anointed
with oil, and by not making too great stretches, and having the body,
about the loins and to the hollow of the ribs, bound round, in sum«
mer, with a swath of a soft consistence, six or seven fingers broad,
and in length not less than five cubits. A staff also will be useful
for the journey ; for in going down a declivity, by putting it before
\X will support the body l&e a pole, and by leaning upon it in
fUBcending it will assist in raising the body. When a traveller
stops, he should get his body anointed, take some food adapted for
the summer, and a moderate quantity of drink. After dinner, he
ought to rest a while before proceeding. But if compelled to go
on, and oppressed with thirst, he may drink water having some
polenta sprinkled upon it, with a moderate quantity of salt. He
should be careful of heat and of the sun, and have his body covered,
80 as not to be exposed to the sui^ lest during the journey his limbs
become dry and stiff. With these precautions, he will be less liable
to lassitude and its accompanying evils. In winter, as it is cold, be-
fore setting out he ought to evacuate, get his body rubbed with oil,
take plenty of the winter articles of food, and a little drink. He
should also get not only his loins, but likewise his spine and cUest
BOOK FIRST. 29
properly bound round with a broader swath. When he re^ts, if th6
cold be great, it will be better that he neither anoint, nor take food
or drink, nor any other refreshment, if he means to remain there.
But after long journeys, or excessive fatigue of any kind, even
if a person do not complain of lassitude, it will be proper to treat
him like those who do, for thereby there will be less danger of any
bad consequences.
LVI. — Of the regimen of Persons at Sea.
With regard to the vomitings which occur to people at sea, it is
neither easy nor expedient to contend with those which happen first ;
for, upon the whole, they are generally beneficial. After vomiting,
one ought not to use much, nor ordinary food, but either lentils, dried
and boiled with a small quantity of penny-royal, or bread pounded in
a weak and fragrant wine. One ought also to use but little drinkt
and that containing a weak watery wine, or vinegar with honey.
The lentils ought to be first boiled, and then when they become soft,
to be triturated, and afterwards dried and put into an earthen vessel.
When severe vomiting lasts for a long time, one should resolutely
abstain from all kinds of food, and take only a little drink, which
ought to be vinegar and honey with water, containing thyme in-
fused in it, or penny-royal water with some fine polenta, or some
fragrant weak wine with fine polenta also. In order to overcome
the disagreeable stench on board ships, one may smell to quinces»
thyme, or penny-royal. One ought also to look as seldom as pos-
sible upon the sea, until one has been accustomed lo live in a ship.
One must likewise attend, that the water which is drunk be not
muddy, ill-smelled, or saltish.
ItVII. — For dimifdshinff Obesity.
When the body gets to an immoderate degree of obesity, it will
be necessary to melt it down and reduce it. It was mentioned
formerly, that the warm temperament renders the body lean, and
therefore it ought to be superinduced, if possible, upon that of fat
people, in order to reduce them to the proper state. You have
also learned that active exercise, an attenuant regimen, medicines of
the same class, and mental anxiety, bring on the dry tempera-
ment, and thereby render the body lean. What an attenuant diet
consists of is perfectly obvious ; but the more powerful medicines,
such as the seed of rue, particularly the wild, with its tops, the
round birth wort (aristolochia rotunda), the small centaury, gentian,
poley, and the stronger diuretic medicines, as Macedonian parsley ;
all such medicines, either alone, or together, evacuate the humours,
and reduce the body. The salts also from burned vipers and the
theriac attenuate the body. The body may also be reduced and
attenuated, by having an oil rubbed into it, containing the root of
30 PAULUS ^OINETA.
the wild cucttmber, marshmallowB, gentian, and the root of the all-
heal and birthwort, or the poley and centaury. One ought not to take
food immediately after the bath, but should first sleep for a little
time. And it ¥dll be of consequence, if the water of the bath pos-
sess diaphoretic properties, and» more particularly, if we can have
recourse to a natural one, such as that in Mitylene. If it cannot
be procured, the flower of salt may be mixed with sea- water. Thin
white wines ought to be used. Dry rubbing with thick towels is
calculated to reduce the iiit. A small quantity of food ought to be
given in proportion to the exercise taken. Insolation also is of use
for obesity. Fat persons ought not to take a fragrant draught before
a meal ; and it will be best if they eat only once in the day. The body
ought to be rubbed with nitre (soda), and the rougher salts. A large
quantity of nitre in the bath is attenuant, but a small quantity only
atimulates to nourishment. The following mixture is attenuant : —
Of pepper and Macedonian parsley, two parts, of asarabacca and
anise, one-half. This acts well, both as a diuretic and a cathartic.
LVIII. — How to recruit those who are Emaciated.
Whbn we wish to recruit those who are reduced in flesh, we
must give them thick wine and food containing thick juices, and
prescribe slow exercise and moderate friction, — in a word, every
thing contrary to the method we have been just describing. It
may also be of use to be pitched for three or four days. If one
go into the bath with an empty stomach, he ought beforehand to
get his body rubbed with linen cloths until it become ruddy, and
afterwards, by hard but not frequent friction, the skin may be ren^
dered thick and hard. Those who are pale, and not properly nourish-
ed» ought to be roused to anger and mental emotions.
LIX. — How to remedy emaciated parts of the Body.
Whbn emaciation takes place in any part of the body, it is com-
monly occasioned by long-protracted rest, or by bandaging for
fractures. We must, therefore, stimulate their vital powers, and
attract the blood to them, by using moderate friction, suitable exer-
cise» and pouring warm water upon them in moderate quantity.
This must be done until the part becomes red and swells, and we
must desist before it subside. We must also use pitching, as for-
merly described. When there is a sense of cold in the part, it ought
to be rubbed with linen cloths, or some calefacient medicine. For
this purpose, I have sometimes used the thapsia, rubbing it in either
with honey or cerate.
I4X. — Description of the best Temperament.
That man is in the best temperament of body when it is in a
medium between all extremes, of leanness and obesity, of softness
BOOK FIRST. 31
and hardness, of heat and cold, of 'moisture and dryness ; and, in a
word, who has all the natural and vital energies in a faultless state.
His hair, also, should be neither thick nor thin, neither black nor
white. When a boy, his lodiis should be rather tawny than b1ack»
but, when an adult, the contrarywise.
LXI. — Description of the Intemperaments.
Thosb bodies which are of a hotter temperament than the moder-
ate ¥nll have their teeth earlier than usual, and will grow in like
manner. They feel warmer to the touch, and have less fat ; they
are of a ruddy colour, have their hair black and moderately thick,
and their vems are large. But if such a one be also fat and
brawny, and have large veins, he is fat from habit and not from
nature. The following are the symptoms of a cold temperament :
Such bodies appear cold to the touch, are without hair, and are fat ;
their complexion, like their hair, being tawny. But when the coldness
is great, they are pale, leaden-coloured, and have small veins ; and
if lean, this does not proceed from nature, but habit. The dry is
harder and more slender than the temperate — the hardness, indeed,
being inseparable from the dry temperament ; but leanness not only
follows the connate temperaments, but also those which are ac-
quired by long habit. It is a symptom of hardness when the body
is rendered unapt for motion, dry and parched, by drpng applica-
tions. The humid, in all other respects, is like the temperate,
but is softer and fatter, and the softness is inseparable from it;
but the grossness not only follows the connate temperament, but
also that acquired by long habit. It is peculiar to the humid tem-
perament that the body is oppressed by things of a moist nature.
The warm and dry temperament is extremely shaggy, having the
hair of the head in early age of rapid growth, black, and thick ; but,
in after-life, baldness follows. The veins are large, as are likewise
the arteries, which beat strongly. The whole body is firm, well ar-
ticulated, muscular, and without obesity ; and the skin is hard and
dark. When the temperament is cold and humid, the chest is nar-
row, and like the rest of the body without hairs ; the skin is soft
and white, and its hairs somewhat tawny, especially in youth ; and
such persons do not get bald when they grow old ; they are timid,
spiritless, and inactive ; their veins are invisible ; they are gross and
fat ; their muscles and legs are feeble, and their joints ill-formed ;
and they are bandy-legged. But should the humidity and cold-
ness increase, the colour of their skin and hair becomes tawny,
or, if tiiey increase still more, pale. The hot and humid tempera-
ment is softer and more fleshy than the proper, and, when it in-
creases much, is subject to putrid disorders; but, if it be only a little
more humid and much hotter than the moderate, the bodies of
such persons are only a little more soft and fleshy than the mode-
nite, but they are much more hairy and hotter to the touch. But
if the cold and the dry grow equally together, such persons have
32 PAULUS iEGINETA.
naturally their bodies hard, slender, and white, with fine mnscles,
small joints, and little hair ; and they are cold to the touch. Al-
though slender, fat is mixed with their flesh. The colour of their
hair is correspondent to the degree of constitutional coldness. As
to disposition of mind, they are spiritless, timid, and desponding.
To say all in a word, with regard to the compound temperaments,
they are always to be distinguished by the marks of the prevailing
quality.
LXII. — On the Form of the Head.
A SMALL head indicates a faulty configuration of the brain, bat
a large is not necessarily a good one ; for if occasioned by the
strength of the vital powers of the part fabricating an abundant and
proper matter, it is a good sign ; but if occasioned by the quan-
tity of matter alone, it is not good. We must judge of heads then
from their shape, and from the processes which arise from them —
from their shape, if well formed, for that is always a good sign —
and from the processes of the brain, if they be in their proper state,
and if the tendinous parts be all properly nourished, have their suita-
ble tonefand if the sight be acute. Sharp heads are defective in the
protuberance of the front or hind-head, or else it is unnaturally in*
creased. Now, in most cases we shall find that these last, like the
large, are faulty, and yet some of them, though rarely, are good,
being occasioned by the strength of the formative principle.
LXIII. — How to know ike Temperament of the Brain.
A BRAIN of the proper temperament has its vital energies and ex-
cretions moderate, and is not liable to be affected by any externals.
Such persons, when infants, have the hair of their head somewhat
tawny — when boys, yellowish — and when adults, a bright yellow ;
being also intermediate between the curly and the straight, and
they do not readily fall out. When the temperament is hotter
than moderate, all the parts about the head are hotter and redder,
the veins in their eyes are distinguishable, their hair is grown at
birth ; and if much hotter, it is black, strong, and curly ; but if
not much, it is yellowish at first, and then grows black, and in
more advanced life such persons become bald ; their excretions are
small when they enjoy good health ; their head becomes filled and
oppressed by heating food, drink, and odours, or by any external
applications of the same nature. Sach temperaments are satisfied
with little sleep, and even that is generally not profound. The fol-
lowing are the marks of a brain which is colder than proper : — ^The
excretions are in large quantity; the hairs are straight, yellow,
and durable ; and it is hurt readily by cold things. Such persons
are constantly seized with catarrhs and defluxions, the veins of their
eyes are not visible, and they are given to drowsiness. The follow-
BOOK FIRST. 33
iDg are the marks of a brain which is drier than natural : — The ex-
cretions small, and the senses acute, not given to drowsiness, the hair
strong and soon formed, rather curly, and soon falling out. In the
more humid temperament, the hairs are straight, do not readily fall
out ; the senses are blunt, and the excretions redundant, sleep long
and profound. In the compound of the hot and dry, the excretions
of the head are small, the senses acute, there is a disposition to
watchfulness, and baldness. Their hair at first is formed quickly
and abundantly, is of a black colour, hot to the touch, and red until
manhood. But if moisture be joined to )^eat, and they are not im-
moderate, the colour and heat are good, and the veins of the eyes
large. The excretions are plenteous and well concocted. The hair
is straight and yellowish, and does not readily fall out. The head
is easily filled and oppressed by hot and humid things. But should
an increase of humidity and heat take place, the head becomes dis-
eased, and easily affected by heating and diluent things. Such per-
sons cannot endure long watchfulness, but their sleep is disturbed
by phantastical dreams, their sight is dim, and their senses not dis-
tinct. The cold and dry temperaments of the brain conjoined to-
gether render the head cold and pale, the veins of their eyes do not
appear, and they are readily hurt by cold things. Wherefore, their
health is precarious. Their senses in youth are distinct and fault-
less, but as they advance in life soon decay. In a word, as far as re-
gards the head« they experience a premature old age; their hair after
birth is of slow growth, dry and tawny. The humid and cold tempera-
ments of the brain render those affected with them prone to lethargy
and drowsiness ; their senses are bad ; they abound with recremen-
titious humours; are easily affected with cold and fulness of the head;
and are liable to catarrhs and defiuxions ; but do not readily become
bald.
LXIV. — Description of the Temperaments of the Stomach.
Thb symptoms of an unusual dryness of the stomach are, that
those affected with it are liable to thirst, but little satisfies them ;
and they are oppressed with much drink, as the superfluity occasions
gurgling in, or floats upon, the stomach ; of those of a more humid,
that they are not addicted to thirst, and bear readily much liquids,
and rejoice in humid food. A stomach unusually hot has a better
digest ipn than appetite, particularly with regard to those things
which are hard and difi&cult to change ; it delights in much food
and drink ; neither is it hurt by the moderate use of cold things.
An unusually cold stomach has a good appetite, but not a good
digestion, in particular with regard to such things as are difficult
to change, and are of a cold nature, which therefore are apt to turn
acid in it. And it delights indeed in cold things, but is readily
hart by the immoderate use of them. The bad temperaments pro-
ceeding from disease differ from the cengenital in this, that they
long for opposite things, and not always alike. If the stomach
34 PAULUg iEGINETA.
then digests properly, it is of a moderate temperament ; tnd if it
does not, it is of a bad ; but if its eructations are fetid , its heat is
inordinate and inflammatory ; but if acid, the contrary. And in
those who digest properly things of difficult digestion, the heat of
the stomach is inordinate, and weak in those who cannot digest
them, but digest fishes. It must also be observed, whether or not
the symptom is occasioned by any humour flowing from another
part ; for in pituitous constitutions acid eructations are apt to occur ;
but in the bilious, fetid airs and other disagreeable qualities are apt
to prevail. The common, sjrmptom of them all is nausea. If the
depraved humours are lodged within the cavity of the stomach, they
float on the surface, and are discharged by vomiting ; but if they
are contained in the substance of it within its coats, they annoy it
with vain attempts to vomit.
LXV. — On the Temperaments of the Lungs.
Not only does the stomach render us thirsty and otherwise, and
excite a desire of warm and cold drink, but also the thoracic vis-
cera, namely, the heart and lungs, and likewise the liver. And "
drinking does not straightway allay the desire, but a small quantity
of cold drink will rather allay the thirst than a great quantity of
warm. Persons so aflected are cooled by inhaling cold air, which
has no eflect in alleviating the thirst of the stomach. Thus, also,
those who are contrariwise affected suffer sensibly from breathing
cold air. This is the best indication of coldness of the lujigs, but
they hawk up phlegm, and expectorate it by coughmg. Dryness of
the lungs is marked by freedom from excrementitious discharges and
from phlegm ; and humidity, by being excrementitious, and render-
ing the voice dull and hoarse ; and the recrementitious discharge is
also very great when theyattempt to speak in a louder or sharper tone.
LXVI. — On the Ten^eramenta of the Heart.
Thesb are the symptoms of an unusually warm heart ; large-
ness of respiration, frequency and density of pulse, boldness and
maniacal ferocity , the chest is covered with hair, particularly the
breast, and usually, the parts of the hypochondriac regions adjoining
to it ; and the whole body is hot, unless the liver powerfully anta-
gonise. And capacity of chest is also an indication of heat, unless
the brain in that case antagonise. But an unusually cold heart
has the pulse smaller than moderate, and such persons are timid
and spiritless, more especially if there be no hairs on the breast.
Ihyness of the heart renders the pulse hard, and the disposition not
prone to anger, but fierce and difficult to quell ; and, for the most
part, the whole body is drier than usual, imless the liver antago-
nise. These are the marks of a more humid temperament ; a soft
pulse, a disposition easily roused to anger, and easily pacified, and
BOOK FIRST. 35
the ¥%ole body more humid than common, unless antagonised by the
liver. When the temperament is both hotter and drier, the pulse
is large and hard, quick and dense ; and the respirations large,
quick, and dense. Such persons have much hair upon the breast
and hypochondrium ; they are prone to action, given to anger, fierce
and tyrannical in their dispositions, for they are both passionate
and implacable. But, if humidity prevails with heat, such persons
are less covered with hair than the afore-mentioned ; they are prompt
to action, their disposition is not fierce, but only prone to anger ;
their pulse is large, soft, quick, and dense. But when the tem-
perament is more humid and cold than common, the pulse is soft,
the disposition spiritless, timid and sluggish ; they have no hair on
the breast, and neither indulge in lasting resentment, nor are prone
to anger. A cold and dry heart renders the pulse harder and small.
Of all others, such persons are least given to anger, but when pro-
vided they retain their resentment. They are also particularly dis-
tinguished by having no hair on the breast.
LXVII* — On the Temperaments qf the Liver,
Thx 83n3iptom8 of a hot liver are largeness of the veins, redun-
dance of yellow bile, and, in manhood, of black ; the blood hotter
than natiural, and by means of it the whole body, unless the heart
antagonise ; and thick hairs upon the hjrpochondriac regions, and
over the stomach. Those of a cold, are smallness of the veins,
much phlegm, cold blood ; the whole habit of the body colder than
common, imless warmed by the heart ; no hair on the hypochondriac
regions, nor over the stomach. Those of a dry are, thick and
scanty blood, and the veins and the habit of the whole body drier.
Those of a humid are, the blood abundant and liquid, the veins
softer, as also the whole body, unless the heart antagonise. The
symptoms of a temperament at once hot and dry are, the hairs very
thick on the hypochondrium, the blood at the same time thicker and
more scanty, a redundance of bitter bile, and, in manhood, of blacky
largeness and hardness of the veins, and the whole body hot and
dry* The heat proceeding from the heart may indeed overcome the
coldness proceeding from the liver, in like manner as the coldness
may the heat ; but it is not possible for the dr3mess to be changed
to the contrary state by the humidity of the heart. It is obvious
that* when the temperaments of those two prime organs combine to-
gether, the whole body is affected accordingly. But the humid
and hot liver, less than the hot and dry, renders the hypochondrium
shaggy ; but the blood is abundant, the veins large, and the whole
habit humid and hot, unless the heart antagonise. But, should
both these qualities be pretematurally increased, persons so affected
will be readily seized with putrid diseases and disorders from bad
bunours ; and more particularly if the humidity be much increased,
and the heat but little, they will be liable to cacochymies. In the
hwnid and cold, the hypochondrium is free from hairs, but the blood
D 2
36 PAULUS iEGINETA.
is pituitous, the veins contracted, and the whole body in like^an-
iier, unless changed by the heart to the opposite state. The cold
and dry renders the blood scanty, the veins of the body contracted,
and the body colder ; and the hypochondrium is without hair, un-
less the heart overcome this state.
LXVIII. — On the Temperaments of the Testicles.
Of the temperaments of the testicles, the hot is lustful, apt to
generate, particularly males, and has the genital parts covered with
thick hairs, which extend to the surrounding part. The cold is
the reverse. In the humid, the semen is copious and watery. In
the dry, it is scanty and thick. A temperament which is mode-
rately hot and dry has very thick semen, is most prolific, and
rouses the person to early indulgence. Such persons have, at a very
early period, thick hstirs on their genital organs, and on the sur-
rounding parts, as high up as the navel, and as low down as the mid-
dle of the thighs. Such a temperament is prone to venery, but is soon
satiated, and readily hurt if compelled. When humidity combines
with heat, such persons have thick hair, and much semen ; yet they
have not greater desires than others, but they can bear much ve-
nery without injury : and, if both the moist and the hot combine
properly together, they cannot safely abstain from venery. Those
whose testicles are of the humid and cold temperament have no
hair on the neighbouring parts ; they are slow in beginning to co-
pulate, and not much prone to the exertion. Their semen is wa-
tery, thin, without strength, and fit only for begetting females.
The dry and the cold temperament together resembles the former
in every other respect, except that the semen is thicker, and alto-
gether scanty.
LXIX. — On the Parts that are omitted.
Each of our members has its own proper temperament and fa-
culty ; but it is not necessary for us to describe the characters of
all, since they are unlimited, and we propose to give only a brief
system of instruction. Having treated of those which principally
affect the whole bbdy; of the others, we shall merely direct to
judge in the same way, forming an opinion of the temperaments
from their excretions, their other energies and symptoms. It is
now time to treat of the cure of the intemperaments of the whole
body.
LXX. — On the Cure of Hot Intemperaments of the Body,
Since, when hot intemperaments prevail, the bile exceeds in
quantity, if it pass downward, little, it is obvious, need be done ; but.
BOOK FIRST. 3/
if carried upwards to the stomach, it ought to be evacuated by vomit-
ing, by taking tepid water after exercise and before food. It will be
better that the exercise, be not swift nor hard ; but» on the con*
trary, rather slow and gentle. Some of those who are very hot do
not at all require gymnastic exercises, but walking and the bath are
sufficient for them. These delight also in baths after a meal. But
those who have heat combined with dryness require a diluent regi*
men by means of succulent food, baths, and abstinence from much
and hard exercise ; so that in the season of summer they ought to
bathe early, and after a meal a second time. Cold drink is of ser-
vice to them. Venery is most inimical to dry temperaments. Such
ought also to abstain from exertions producing, lassitude, exposure
to the sun, and to avoid cares and watchfulness. Those who are
naturally humid are apt in infancy to be seized with rheumatic and
plethoric complaints, and also with putrid. They stand in need of
more exercise, of a proper digestion, in the stomach, and of secre*
tions by urine. Wherefore such persons are much benefited by tak*
ing before diet the bath two or three times, particularly the natural
hot ones. They ought also to promote the secretions by means of
exercises, and the bath, and by procuring the alvine and urinary
discharges before taking food. And nothing hinders them to use
masticatories and cathartics, as also a whole&ome diet, and wine of
a diuretic quality.
LXXI. — On tfie Cure of the Cold hihmperaments of the Body,
Of cold intemperaments, there are three varieties, of which the
worst is the dry : for such persons are from the first in that state
which time brings upon old men. They ought, therefore, to use
whatever is diluting and warming, such as moderate exercise, hu-
mid and warm food, the heating wines, and much sleep. Care
should be taken, that all the excrementitious matters collected in
the body be evacuated every day. Venery hurts all those who are
affected with dryness, and more especially if joined to coldness, and
is innocuous to the hot and humid alone. The cold and humid
temperaments are bad, and are very subject to rheumatic afiections.
They are relieved by abstinence from the bath, by frequent and light
exercises, and the use of moderately warm unguents. Those that
are naturally colder, but are well regulated as to dryness and humi-
dity of temperament, ought to stimulate and increase their heat, but
to choose the medium between a humid and dry diet.
LXXII. — On the Cure of the Dry Intemperaments^ of the
Stomach for example ; then of the other Intemperaments,
A DRY intemperament may either be occasioned by the solid parts*
of uniform texture being drier than natural, which is incurable ; or
by the natural moisture from which these parts derive their nourish-
38 PAULUS JSGINETA.
ment being lost. It is contained in all parts of an animal, being
diffased tbrough them in the form of dew, and can only be supplied
by means of the food. The former variety is utterly incurable ; and
even the latter is of all states of the body the most intractable.
But when the dr3nie8s is seated in the small veins and arteries, the
cure may be attempted by filling each of the parts of uniform tex-
ture with their proper juices by a hnmid diet. A tepid bath is there-
fore beneficial, and the patient ought to remain long in it. Immedi-
ately after the bath, let him take the milk of an ass newly drawn,
to which a little warm honey has been added Afterwards he ought
to rest until he take a second bath. He ought then to be mode-
rately rubbed with oil, if the milk appears to be digested, which
may be judged of from his eructations and the detension of his
belly. The proper interval between the first and second bath may
be four or five hours at the equinox, if he be to bathe a third time,
but, if not, it may be greater. And he ought to be rubbed with oil
before putting on his clothes after every bathing. If^ therefore,
the milk agreed with him, we may give it to him after the second
time, or, if not, we may give instead a ptisan properly boiled, or
alica made into a ptisan. He is then to rest until the third bath-
ing, or, otherwise until supper. His bread ought to be carefully
prepared, baked in an oven, and of a fine quality. With the bread,
he may cat those fishes which are caught among rocks, or the had-
dock in a white soup. In a word, his food ought to be of easy di-
gestion and nutritious, not oily and excrementitious. His drink
should be wine that is weak, white, clear, bearing little water, and
having some astringency. Such is the mode of cure for the great-
est degree of dryness, but the moderate does not require the same
restriction as to diet, which may therefore be more generous. Let
us suppose a dryness like the former, but mixed with a moderate
coldness. In this case, we must substitute certain calefacient arti-
cles ; and, with regard to those mentioned above, we must add
more honey to the milk, and give wine that is not so watery. We
must also not only use things which are naturally heating, but which
are so from their acquired qualities. And the body is to be rubbed
frequently with the ointment of nard and mastich. When much
coldness is joined to the dryness, know, in the first place, that the
complaint is difiicult and intractable, but tise the san^ remedies,,
and also by itself honey that has been boiled and scummed, along
with very old wine. The best possible remedy is that which i»
much used by Pitchers ; and we must likewise rub the belly with
it, and tear it away while it is yet warm. Such persons are also
relieved by having a child of a full habit sleeping with them, so
as to touch their belly. Let us next suppose that a moderate heat
is joined to dryness. In this case, our first care ought to be, not to
taste honey, and to use wine which is not aged, food which is tepid
and milky, and to rub the belly with the oil of unripe olives, or with
that of apples. But to cool such persons much is not devoid of
danger, as the state is feverish when the heat prevails. Let us next
suppose that a hot intemperament prevails,^and that humidity is joined
BOOK FIRST. 39
to it. Such an intemperament is to be cured by drinking cold water.
The use of astringent food is also proper ; namely, such things as
are austere, without being heating. But when the humid intempera-
ment alone prevails, it is to be cured by such articles of food as are
desiccant, without heating or cooling much, and also by abstinence
from the common drinks. When the humid intemperament is joined
with the cold, the best remedies are all acrid things, and they ought
to be mixed with such things as are astringent, without being re-
frigerant. The drink should be in small quantity, and consist of
some of the strongly heating wines. These are the modes of cur-
ing intemperaments proceeding from qualities. But since a humour
contained within the cavity of the stomach, or being absorbed with-
in its coats, often occasions intemperaments, it will be proper to treat
also of these affections. If the former state occur at once, it may be
easily removed, by emetics ; but if it be a defluxion, the parts it comes
from will require very attentive consideration, and the cure will
follow, of course ; for it is to be applied entirely to the affected
part ; and of the other parts, we need only take care that they be
not thereby affected. The cure is to be performed by astringents,
and such things as will bring the body to its proper habit. De-
praved humours in the coats of the stomach, are to be evacuated by
moderately cathartic medicines, such as aloes, and the powder pre-
pared from it, called picra. When a viscid phlegm is contained in
the stomach, such persons ought to take those things which will
cut it, and then it may be purged off, or evacuated by vomiting
with radishes. When the humour is neither viscid nor thick, a
vomit from ptisan, or that from honied water, may be sufficient.
The juice of wormwood with honied water may also be drunk. In
like manner, intemperaments in other parts maybe cured, by finding
out the evacuation suited to the humours ; or, if the part has no
sensible discharge, the prevailing matter and humours may be
evacuated in the form of vapour ; and in like manner, if it proceed
from flatulence.
LXXIII. — On the Powers of the Articles of Food.
SiNCB an account of the properties of food is a part of the doc-
trine of Hygiene, we shall add that to the preceding, having premised
only a few remarks before delivering the particular rules on this
head ; for nothing is more indispensably necessary than to be well
acquainted with the properties of food. Things of an attenuating
power open the pores, and clear away the viscid humours which are
impacted in them, and cut and attenuate the thick ; but when per-
severed in as articles of food, they beget serous and bilious super-
fluities, or, if still longer continued, they render the blood melan-
cholic. One ought therefore to abstain from the continued use of
them, and in particular those who are of a bilious temperament ; for
they only suit with those who have collections of phlegm, and of
crude, viscid, and thick humours. Those of incrassating powers are
40 PAULUS .EGINETA.
sufficiently nutritious, and, if properly digested in the stomach and
liver, they form good blood, but occasion obstructions of the spleen
and liver. Of these some have only thick juices, as the dried lentil,
but some viscid, as the mallows ; and in some they are both thick
and viscid, as the testaceous fishes. An attenuating diet is safer
than an incrassating for the preservation of health, but yet, as it
supplies little nourishment, it does not impart tone or strength to
the body. One ought, therefore, to take some moderately nutri-
tious diet, when experiencing the effects of a deficient diet. They
may do so with the least danger who are given to exercises and can
take as much rest as they please. But all those who cannot take
exercise before food ought to avoid such things as are incrassating ;
and those who are of an indolent habit ought by no means to take
such food. For complete inactivity is one of the greatest evils for
the preservation of health, whereas moderate exercise is particularly
good. Those articles of food which are intermediate between the
incrassating and the attenuating are the best of all, producing blood
of a proper consistency. Such a diet, then, agrees with our bodies,
but that which produces a bad chyme ought to be shunned. It is
better also to avoid variety of food, more particularly if it consist of
contrary qualities; for such things, when taken together, do not
digest properly.
LXXiy.— On Pot'Herb».
The lettuce is manifestly refrigerant and diluent ; it is therefore
soporific, and, compared with other pot-herbs, nutritious, forming
blood of a very good quality. The endive is refrigerant and di-
luent, but less so than the lettuce. The mallows cool but not ob-
viously, they rather moisten and thereby loosen the belly ; and this
they do by means of the viscid juice which they contain. The beet
is detergent, and thereby softens the belly, but when eaten in great
quantity it occasions pain of the stomach : it removes obstructions
of the liver and spleen. The cabbage, when twice boiled before it
is eaten, binds the belly, but when only once boiled for a short time,
it rather loosens, if eaten with oil, sauce, or salts ; as its juice, still
more than the dried lentil, is of a purgative quality; and in particu-
lar the sea-cabbage is laxative of the belly, being manifestly saltish
and bitter. The sea- purslane-tree, possessing stronger saline qua-
lities, loosens the belly, and agrees better with the stomach than
the cabbage, from having a moderate astringency; it is also fitted
for forming milk and semen. The blite and orache (atriplex hortensisj
are succulent and laxative, but not nutritious. All the thorny tribe,
such as the golden thistle, the atractylis, and such like are stomachic,
except the artichoke (cinara), for, being hard, it forms bad chyme ;
and, therefore, it is best to take it boiled with oil, fish-sauce, and
coriander. The -parsley, the horse-parsley (Smyrnium olusatrum)^
the water parsnip, and the allsander, are diuretic ; but the allsan •
der is aromatic, and more acrid, diuretic, and emmenagogue, where-
BOOK FIRST. 41
as the parsley and horse- parsley are sweeter, and, therefore, agree
better with the stomach. The rocket (braasica eruca) is hot, and
forms semen ; and, therefore, rouses to venery and occasions head-
achs. The cress, basil {pcimum), and mustard, are hot and acrid,
particularly the cress; but all are of difficult digestion, injure the
stomach, and supply unwholesome juices. But the nettle is of subtil
parts, laxative, and of little nourishment. The tooth-pick-fennel
is like the shepherd's-needle, possessing astringent and bitter quali-
ties in no small degree ; it is beneficial to the stomach, so that those
who have lost their appetite may eat it with advantage in vinegar ;
but it supplies little nourishment to the body. All the wild pot-
herbs, as they are called, contain very bad juices. Cappers, how-
ever, whets the' appetite, removes obstructions of the liver and
spleen, and evacuates phlegm. It is to be used with vinegar and
honey, or with vinegar and oil, before taking any other food.
LXXV. — On Asparagi or Young Shoots.
Blitbs, lettuces, orachs, mallows, and beets, have the plant juicy,
but the shoot dry. The turnip, mustard, radish, cress, pellitory,
cabbage, and other hot things, have the plant of a dry, but the
shoot of a juicy nature. The shoots of the bushy shrubs, both the
marsh and garden, and that of the bryony, are stomachic and
diuretic, but of little nourishment, yet when digested they are more
nutritious than those of pot-herbs. Such also are the shoots of
the ground-bay.
LXXVI. — On Herbs tvith Esculent Roots.
Tub bunias or turnip, when eaten after being twice boiled, is nu-
tritious, no less so than other herbs, but when frequently taken it
engenders thick juices. The bulbi are astringent and detergent,
whet the appetite, strengthen the stomach, and evacuate the viscid
humours contained in the chest. When twice boiled, they are
more nourishing, but less expectorant, having lost their bitter prin-
ciple. They increase the secretion of semen, excite to venery when
liberally used, and occasion flatulence and griping. When eaten
with fish-sauce and oil, they are very sweet, do not create flatulence,
are nutritious and digestible. The garden and wild carrot, and
the caraway, have roots which are less nutritious than turnip, but
hut, manitestly aromatic, and diuretic. But when used too freely,
they supply bad juices, and become of difficult digestion like other
roots. Some call the wild carrot daucus ; it is evidently more diu-
retic than the other. The radish is of an attenuant and heating
nature ; but may be eaten before other food along with vinegar and
fish-sauce, to loosen the belly, but by no means after a meal. The
onion, garlic, leek, and dog-leek (ampeloprason) ,he\ng of an acrid na-
ture, warm the body, attenuate and cut the thick humours contained in
42 V PAULUS .fiGINETA.
it ; when twice boiled, they give little nourishment, but when un-
boiled they do not nourish at all. The garlic is more deobstruent
and diaphoretic than the others ; and the dog-leek being wild, is
drier than the common leek. Regarding pot-herbs in general, the
raw, when eaten, furnish worse juices than the boiled, as they have
more excrementitious juice. But those which are prepared for pickles
with brine or vinegar and salt are stomachic, and whet the appetite*
and discuss crude humours ; but are of difficult digestion, and sup-
ply bad juices when too freely taken.
LXXVIL — On Truffles and Mushrooms.
The truffle {tuber) forms chyme devoid of qualities, but cold
and thick. The mushrooms called myceta form phlegm and bad
chyme, being of a cold nature. Of these, the holeti are devoid of
qualities, and are safer than the others when bSiled properly. The
ammanita are of the second order. The other mushrooms ought
not to be tasted, for many of them are mortal poisons ; and even
the boleti, when eaten without being properly boiled, have often oc-
casioned danger.
LXXVIII.— 0» the Frumentaceous Articles of Food.
Of the frumentacea, the chondrus is nutricious, and forms viscid
chyme ; but a watery preparation is unwholesome, because, as it
thickens quickly, it remains raw and unconcocted ; but the juice of
it is better when it is properly boiled whole like a ptisan. The
alica in other respects resembles the chondrus, only that it binds
the belly more. Wheat, when boiled and eaten, is of difficult diges-
tion and flatulent ; but if digested it proves a very strong food.
When made into bread, its indigestible and flatulent properties are
removed by the yeast and salt which are added. The most nutri*
tious of all the kinds of bread is that made from siligo ; next, that
from the similago ; and, third, that which is composed of all to-
gether, and retaining the bran. Coarse bread is less nutritious,
but more laxative than the other kinds. Starch gives little nourish-
ment like washed bread. Barley is of a cold nature and detergent.
When boiled like a ptisan it humectates ; but when toasted, as in
polenta, it dries. Polenta in summer, drunk with water before the
bath, quenches thirst. Barley-bread is dry and of little nourish-
ment. The pudding (maza) is of more difficult digestion, and more
flatulent than barley-bread, and when it receives a little honey is
laxative. Oats are heating and of little nourishment. Millet and
panic are cold and dry, contain little nourishment, and bind the
belly. But the millet is in every respect superior to the panic.
Rice is of difficult digestion, contains little nourishment, and binds
the belly. A ptisan is prepared, by adding one part of it to fifteen
parts of water, then mixing a moderate quantity of oil, and after it
BOOK FIRST. 43
swells up, some vinegar. When properly boiled, a small quantity
of salt is to be thrown in, and sometimes leeks or dill may be added.
Oats and chondrus may be prepared similarly to this ptisan.
LXXIX.— 0» Pube.
Of pulse, the lentil forms a bad chyme and melancholic humours;
but, when twice boiled, it binds the beUy ; yet, its decoction when
drunk with oil and sauce is rather laxative. But savoury or pen-
ujtojbI ought to be added to it because it is flatulent. The com-
mon bean is light, flatulent, and detergent; but the Egyptian bean
is much more succulent and excrementitious than ours. The pea is
spongy, but not so flatulent. The chick-peas are flatulent and de-
tergent, promote the formation of semen, are aphrodisiacal, and H-
thontriptic ; when toasted, they part with their flatulence, but are
of difficult digestion. Lupines are difficult to digest and evacuate,
and produce a bad chyme. The fenugreek warms and loosens the
beUy when taken before a meal. TatBS and fasels having been pre-
viously macerated in water so as to shoot out roots, are laxative of
the belly when taken before a meal with sauce ; and are more nu-
tritious than the fenugreek. But the fasels callckl^ifo/tcAf, when
eaten green with their husks, are more excretnentitious.
LXXX. — On the 8ummer Fruits.
Ths gourd is of a cold and humid nature, loosens the belly, and
gives little nourishment. The pompion is altogether a fruit of bad
juices, cold, humid and emetic ; and, when not properly digested,
it occasions cholera. The seed of it is diuretic, breaks down stones
in the kidneys, and is altogether very detergent. The squash has
all the properties of the pompion in an inferior degree. The cucum-
ber is of a less cold and humid nature than the pompion, but is
more diuretic ; it is difficult to digest, and its chyme is bad even when
digested. Upon the whole, all this class of fruits are of a cold and
homid nature, supply little nourishment, and that of a bad quality.
LXXXI.— 0» the Fruit of Trees.
Thb fig and the grape hold the principal place in this class of
fruits ; for their juices are of a less bad quality, and they are more
mitritious than tiie others. — ^Of these, the figs have the better juices
and the more nutritious ; they are laxative, diuretic, and evacuate
the kidneys, and particularly the very ripe. In like manner also the
dried ; but they are flatulent, and form blood which is not good ;
wherefore, when liberally used, they engender lice. When grapes
are not evacuated, neither are they digested, but form a crude
chyme; but if evacuated their eflects are more moderate. Dried
grapes are wanner than the others, more stomachic, and more nu-
44 PAULUS ili:GIN£TA.
tritious, but not so laxative. The mulberry is of a moistening na-
ture, cools moderately, and loosens the belly when taken first, nei«
ther does it disagree with the stomach, but is little nutritious. — Of
cherries, the sweeter kinds loosen the belly, but are bad for the
stomach ; those which possess astringency are not so bad for the
stomach, but do not evacuate the belly. The same rule will apply
to the grape, the mulberry, and many other fruits ; for astringents
in general, when eaten or drunk at the beginning before any other
food, bind the belly ; but they who have their bowels constipated
from atony, and have taken some articles of food of a laxative na-
ture, such as pot-herbs, fishes, or the like, will find that astrin-
gents taken afterwards will, by strengthening the bowels, evacuate
downwards. The fruit of the pine called strobilus has good juices
and thick ; is nutritious, but not of easy digestion. The juices of the
peach are of a bad quality, turn acid, and soon spoil ; and, therefore,
ought to be taken first, that they may readily pass downwards, and
not spoil by remaining in the belly. The fruits called apricots are
superior to the peaches, for they neither turn acid nor spoil so soon,
and are sweet. Of apples, those that are sweet are more heat-
ing, and easier assimilated than the others, especially when roasted
or boiled ; the acid are colder and more calculated to cut the hu-
mours in the stomach; the austere strengthen the stomach and
bind the belly, more especially quinces. Of pears, the large and
ripe are more nutritious than these ; but the pomegranates are cool-
ing, and contain little nourishment. The medlars and services are
more astringent and fitted for a loose belly. Dates are stomachic,
unless very fatty, they bind the belly, form thick and viscid chyme,
and occasion headachs. Of olives, those called drupm injure the
stomach, and form a fatty chyme ; those that are pickled and hung
(halmadea et colynibadesj when eaten beforehand, whet the appetite,
and loosen the belly, more especially if prepared with vinegar, or
vinegar and honey. Of nuts, those called royal (walnuts) are less
nutritious than the filbert, and more stomachic. The green wal-
nuts are more juicy and laxative ; and, if you will strip off the inner
membrane of dried ones which have been macerated in water, they
will become like the green. Almonds have incisive and attenuat-
ing powers, and, therefore, they evacuate the intestines and chest,
and more especially such as are bitter ; and, in like manner, the
pistacs, which are also more calculated for removing obstructions of
the liver. Damascenes loosen the belly when eaten before food,
either xaw or boiled in honied water. The jujubes are of difficult
digestion, injurious to the stomach, and give little nourishment.
Carobs are of difficult digestion, bind the belly, and produce bad
chyme. Sycamores are decidedly of a cooling and a moisten-
ing nature. Of the citron, the outer part is acrid and indigestible,
but that part which is as it were its flesh is nutritious, and yet it
is hard to digest. The inner part, whether acid or watery, is mo-
derately cooling. Acorns are nutritious, no less so than com, but
of difficult digestion, contain thick juices, and are slowly evacuated.
Chesnuts are in every respect superior to them.
BOOK FIRST. 45
LXXXII. — On Animals; and, firsts of FovAs.
The nourishment derived from fowls is less than that from
beasts, and more especially swine, hut it is of easier digestion, par-
ticularly the partridge, wood-cock, pigeon, hen, and pheasant.
That from thrushes, hlackhirds, and small sparrows, (among whom
are those called pyrgitai) is harder ; and still more so the turtle,
wood-pigeon, and duck. But the peacock is still more indigestible,
harder, and more stringy. The flesh of geese and ostriches is ex-
crementitious, and more indigestible than any of the afore-men-
tioned ; except their wings, for they are not less wholesome than the
same parts in other animals. The flesh of the crane is stringy and
hard. In general, the yoimg are more juicy, digestible, and nutri-
tious than the aged, and are more readily evacuated by the belly.
The boiled are superior to the roasted and fricasseed ; and those that
live on dry and mountainous places are more digestible and less
excrementitious than those which live in marshy places.
LXXXIII.— 0» Effgs.
The eggs of hens and pheasants are the best of all ; those of
geese and ostriches the worst : of all animals, fresh eggs are su-
perior to the old. Those that are moderately boiled are most
nutritive ; those that are slightly boiled pass downwards most
easily, and smooth asperities in the throat. All the other kinds
are difficult to digest and evacuate, and contain thick juices, ex«
cept those that are said to be suflbcated. These are prepared by
mixing raw eggs with sauce, wine and oil, and coagulating to a
middling consistence in a double vessel. In this state they are of
easy digestion, and supply good juices. But of all others the fried
are the worst.
LXXXIV.-^On Beasts.
Among quadrupeds, swine's flesh is more nourishing than any
other food, because it is most nearly allied to the human in taste
and sm^ll, as some have declared who have tasted human flesh by
mistake. Bat the nourishment derived from it is viscid and imper-
spirable. That from sheep is excrementitious and supplies bad
juices. That from goats is acrid and has bad juices. But the
worst of all is the flesh of the buck-goat as to the quality of its
juices and to digestion. That of oxen forms melancholic humours ;
that of hares has thick juices, but less so than that of sheep and
oxeu. That of roes is hard and of diflicult digestion. In general,
the flesh of young beasts is more humid, softer, and more digestible
than that of the aged ; of gelded animals than of those having tes-
ticles ; and of the well-fed than of the lean.
46 PAULUS JilGINETA.
LXXXV.— On the Parts of Animals.
The extremities are tendinous, without fat and without flesh ;
and are therefore viscid, contain little nourishment, and are laxa-
tive of the belly, except those of birds owing to their great dry-
ness. The moat and ears are gristly and indigestible. The tongue
is spongy, full of blood, and gives little nourishment. The glands
are sweet and friable ; and those of the breast are sweeter than the
others, and, in particular, those of swine which are giving milk.
These are no less nutritious than the flesh. The kidneys and testi-
cles are strong-smelled and indigestible, but those of cocks fed upon
grain are sweet, and supply a good nourishment to the body;
whereas those of bulls, buck-goats, and rams, are indigestible, and
contain bad juices. The brain produces phlegm, thick and bad
chyme, is difficult to evacuate and digest, injurious to the stomach,
and occasions nausea ; but when properly digested it is sufficiently
nutritious. The marrow is oily and sweeter than the brain, but in
other respects resembles it. Fat and suet contain little nourish-
ment, and are hurtful to the stomach. The heart and liver contain
thick juices, are difficult to digest and evacuate. But the liver of
swine is better. The spleen contains bad juices, and occasions me-
lancholic humours. The lungs are more digestible as being spongy,
bat contain less nourishment and form phlegm. The stomach,
womb, and intestines are hard, indigestible, and form phlegm. In
general, the nourishment from wild animals is drier and less excre-
mentitiotts than that from tame. All blood is of difficult digestion,
especially the thick and melancholic as is that of oxen ; but that of
hares is esteemed very delicious, and many are in the practice of
boiling it with the liver, and some with the other viscera. Some
eat also that of young swine ; and even Homer was aware that the
blood of goats is eaten by certain people.
LXXXVL— 0» MilL
Milk, when digested, is nutritive, but is injurious to the gums
and teeth ; and, therefore, after taking it, one ought to rinse one's
mouth, first with honied water, and then with an astringent wine,
It also produces headach, occasions flatulence of the stomach, and
hypochondria, and engenders stones in the kidneys. The more
watery kind contains less nourishment, but is more laxative, while,
on the other hand, the thick is more nutritive, and moves the belly
less. That of the goat is of a middling consistence, as that of the
sheep is thicker ; and it, immediately after the ewe has brought
forth lambs, is thinner, but it afterwards becomes thicker and
worse.
BOOK FIUST. 47
LXXXVIL— On the Drinking 0/ Milk.
Hb who drinks milk ought to abstain from all other food until it
be digested, and pass downwards. It is best therefore to drink it in
the morning, newly milked, and to take no food after it, nor any
bard exercise, because this would make it turn acid. But it is
better to walk about gently, and rest between, without sleeping.
After doing this, the first part will be evacuated, and then one may
drink another part, and when it is evacuated another may be taken.
At first, therefore, it purges properly, not indeed from the rest of
the body, but what was contained in the belly. Afterwards it en-
ters the veins, and nourishes excellently, and is no longer evacuated.
In bilious defluxions, and colliquative diarrhaeas, the milk should be
given boiled. Boil it at first gently, and for a short time, so that
none of it may run over, and that part of it may be consumed. Af-
terwards it may be boiled more and more, taking care not to bum
it, nor convert it into cheese. This will be best guarded against by
boiling it softly, and clearing away what is separated by the agita-
tion. It may be agitated with a smooth and slender reed ; and, if it
boil at the lips, this h-oth may be cleared away with a sponge, for
often the part there spoils all the rest. The milk then, as is said,
ought to be boiled until it become thicker and sweeter than the raw.
And the thin and serous part may be dissipated by putting heated
pebbles into the mUk. Tliis is beneficial in defluxions of the belly,
and particularly in bilious ones.
LXXXVIII. — On Milk that has been separated into Parts.
By powerful boiling at a strong fire without smoke, the serous
part of the milk is separated from the caseous, and is then strained
through a sieve or piece of rag carefully, and to the serous part is
added a moderate quantity of honey, or of vinegar and honey, or
salts ; and it is given to evacuate the bowels in the quantity of two
sextarii to adults, and to younger persons not less than a sextarius.
And milk thickened by ignited pebbles or iron may be given with
advantage for dysenteries and alvine discharges.
LXXXIX. — On Cheese.
All cheese is acrid, occasions thirst, is difficult to digest, forms
bad chyme, and engenders stones. That is best which is new,
spongy, soft, sweet, and has a moderate share of salt. The opposite
kbd is the worst.
48 PAULUS iEGINETA.
XC.—On Fishes.
That all fishes are of a cold and humid temperament is obvious.
Those that are found among rocks are the best, being of easy diges-
tion, furnishing good juices, and being moderately moistening when
their flesh is not hard. Of those that do not dwell among rocks,
the most excellent are those that live in the sea, or where rivers meet
the sea. But still worse are those which are found in marshes and
stagnant parts of the sea. In particular, the pollard (capito) being
a sea fish, is moderately sweet, not very indigestible, furnishes good
chyme, but the blood formed from it is thin and weak. So it is
also with the barb (lupus). The surmullet, as being a sea fish, is
harder than the others, dry, digestible, nutritive, sweet, and free
of fat,
XCI. — On the Testacea.
Thb testacea in general form a saltish and crude chyme; but of them
the oysters have the softest flesh, and are most laxative. The che-
mae, purpuras, solenes, spondyli, buccinse, cochleae, and such like, are
hard. And those covered with a soft shell (crustacea) such as
the astaci, paguri, crabs, common lobsters, and tliose called squillse,
are of diflicult digestion, nutritious, and bind the belly when often
boiled in sweet water. The juices of all the testacea are laxative,
and therefore from the land snails, although their flesh be hard, in-
digestible, nutritious, and contains bad juices, some make a sauce,
with oil and pickle, which they use for opening the belly. The sea
urchins (echini) are moderately cooling, contain little nourishment,
and are diuretic.
XCII. — On the Molltisca.
Thb mollusca, such as polypi, sepise, and loligines, are hard and
indigestible, and particularly the polypi. Their juices are saltish,
but when digested they furnish considerable nourishment to the body,
XCIII. — On the Cartilaffinotis Fishes.
Of the cartilaginous fishes, the torpedo and pastinaca have soft
and sweet flesh, which passes readily downwards, is easily digested,
and proves nutritive. The rays (raitej, leviraiae, skates (squatina),
and the like, are harder and diflicult to digest, and more nutritious.
In general, those animals which have hard flesh are difficult to di-
gest, and contain much nourishment. When properly digested,
they furnish much and substantial nourishment.
BOOK FIRST. 49
XCIV.— On the Cetacea.
Thb cetacea, or whale species, such as the balaense, seals, zygseaae,
dolphin, and great tunnies, have hard and indigestible flesh, con-
taining thick juices. When pickled, they are more moderately so.
And of the other fishes, those which are most humid and excremen-
titions are most fitted for pickling ; but there is the same di£ference
in pickles as in the fishes .^om which they are formed.
XCV. — Oh the Properties of Wine.
He who has taken the subject of health into consideration ought
to be acquainted with the powers of wine. Wine in general is nu-
tritious, but that which is red and thick is more particularly so ; but
its juices are not good. The sweet also is nutritious, but not sto-
machic. The astringent is stomachic, but is distributed with dif-
ficulty to the parts of the body, and nourishes less. The white
nourishes lees still. Wine of a yellow colour is the best of all.
That which is old is more heating and desiccant than the new.
Such, in a word, are the properties of wine. But wine in general
resuscitates the natural heat within us, and therefore it improves
digestion, and forms good blood. And being of a penetrating na-
ture, it difinses the nourishment all over the body, and therefore it
recruits those who are emaciated by disease, for it gives them an
appetite for food. It attenuates phlegm, clears away the bile by
nrine, and imparts a good colour. To the soul also it communicates
gladness and pleasure, and improves the strength. Such are the
good efiects of the moderate use of wine. But its immoderate use
produces just the reverse ; wherefore, those who are drunk become
changed, are delirious^ and disposed to heavy sleep. On that ac-
count, such an immoderate use of wine ought to be avoided ; but at
greater intervals it may be drank liberally, for it promotes the dis-
charges by urine and perspiration. But it is better in such cases to
vomit, by taking, beforehand, of honied water, so that one may not
be injurcMl by it. When one has drunk largely, it is not proper to
take much of any other food ; but while drinking, one should eat
boiled cabbage, and tiMste ^ome sweet meat, particularly almonds.
These things relieve headach, and are not difficult to vomit. It is
also very proper to take the infusion of wormwood before drinking,
for of all things it is the best preservative from surfeit. If one ex-
perience any painful effects from wine, one should drink cold water,
and the next day again the infusion of wormwood; and by using
eiercise, friction, the bath, and restricted food, in this way get
restored to healths
£
50 PAULUS iEOINETA.
XCVI. — On Honey and Honied Water,
Boiled honey is rather nutritive than laxative ; but when un-
boiled the contrary. It agrees with cold and humid temperaments,
but in the warm it is converted into bile. Honied water does not
agree well with those who are affected with bitter bile, being con-
verted into bile. In such constitutions the honied water ought to
be very weak ; but it is not proper for those whose bowels are easily
affected. The honied water may be prepared by adding eight parts
of water to the honey, and thus boiling it until it cease from. froth-
ing. It is expedient also to clear away the scum as soon as
formed.
XCVIL— 0» Sleep.
It remains, after having treated of every thing connected with
diet, to say something of sleep, which is generally taken after every
other thing. Sleep, then, may be briefly defined a relaxation of
the vital powers, occasioned by a suitable humidity irrigating the
brain. When properly taken it may produce many good effects.
It digests the food, concocts the fluids, soothes pain, alleviates
lassitude, and relaxes that which is contracted. It is also calculate'
ed to produce oblivion of mental sufferings, and to rectify the dis-
tracted powers of reason. The most suitable season for sleep is
after a meal. But that during the day does not agree with all, be*
cause the time spent in sleep is not sufficient for the complete
digestion of the food ; and, when the digestion is interrupted unsea-
sonably, those who rise from sleep at noon are often troubled with
acidity and flatulence, and sometimes even with a gargling noise in
their bowels, unless from habit or sufficient rest these bad effects be
obviated. The best season for sleep is the night, for the humidity
and drowsy stillness of night contribute to perfect digestion.
Wherefore after these nocturnal slumbers we feel the most desire
for evacuation. The proper limit to sleep is the complete digesticm
of the food, as may be ascertained by the eructations, and by tap-
ping over the stomach ; after which it may be useful to awake in
order to evacuate the excrementitious renmins of the digestion.
XCVIIL— CM Watchfulness.
The cure of watchfulness in disease, whether proceeding from
pain, fever, or some acute sjrmptom, will be treated of under the
head of fevers, but we shall now treat of the watchfulness of those in
health. If their watchfulness proceed from sorrow, care, or any
mental emotions, we must endeavour if possible to remove the of-
fending cause, and then to divert the attention by agreeable sounds.
For this purpose, some seek after the gentle noise of waters, by
BOOK FIRST. 51
which they are soothed and lulled to rest. After proper digestion,
they should use baths especially in the evening, and a moistening
diet, such as lettuces and the like. They may also mix the green
leaves of the black poppy with condiments, and eat fish of easy di-
gestion. They should sdso use plenty of wine which is light and
not old. When about to go to bed, their heads should be anointed
with rose oil, or with oil in which the heads of poppies or mandrake
have been boiled. And the oil of dill not too old is soporific. I
have known rest succeeding suddenly to fatigue produce this effect.
Moderate coition will sometimes do the same. Others easily pro-
cure rest by having their head and ieet cooled. But if their watch-
fulness be occasioned by their stomachs being oppressed by the
quantity or bad quality of the food (and I have known this happen,
in like manner as in others it arises from an unseasonable absti-
nence or diminution of their accustomed food), this ought to be in-
quired into and the cause removed.
XCIX. — On Somnolency.
If, on the other hand, the sleep be profound and heavy, we must
abstain from frequent baths and cooling unguents ; we must use
masticatories, and upon the whole change the regimen for one of a
hotter, drier, and less nutritive character, because the afifection is
occasioned by a cold and humid matter irrigating the brain.
C. — The Epistk of Diocles on the Preservation of Health, —
IHocles to King Antigomie.
SiMCB of all kings you are the most skilled in the arts, and have
lived longest, and have become acquainted with all philosophy, and
attained the highest rank in mathematics, I, supposing that the
science which treats of whatever relates to health is a branch of phi-
losophy becoming a king and befitting to you, have written you
tins account of the causes of diseases, of the symptoms which pre-
cede them^ and of the modes by which they may be cured. For
neither does a storm gather in the heavens but it is preceded by
certain signs which seamen and skilful men attend to, nor does
any disease attack the human frame without having its precursory
symptoms. If, then, you will only be persuaded by what we say re-
gar&ng them, you may attain a correct acquaintance with these
things. We divide the human body into four parts, the head, the
diest, the belly, and the bladder. When a disease is about to fix in
Ihe head, it is usually preceded by vertigo, pain in the head, heavi-
ness in tiie eye-brows, noise in the ears, and throbbing of the tem-
ples ; the eyes water in the morning, attended with dimness of
sight; the sense of smell is lost, and the gums become swelled.
When any such symptoms occur, the head ought to be purged> not
indeed with any strong medicine, but taking the tops of hyssop and
b3
52 PAULUS iEGlNETA.
sweet marjoram, pound them and boil them in a pot with half a hae-
mina of must or rob, rinse your mouth with this in the morning
before eating, and evacuate the humours by gargling. There i»
no gentler remedy than this for affections of the head. Mustard ia
warm honied water also answers the purpose well. Take a mouth-
ful of this in the morning before eating, gargle and evacuate the
humours. The head also should be warmed by covering it in such
a manner as that the phlegm may be readily discharged. Those who
neglect these symptoms are apt to be seized with the following dis-
orders : inflammations of the eyes, cataracts, pain of the ears as if
from a fracture, strumous affectiopsof the neck, sphacelas of the brain ».
catarrh, quinsy, running ulcers called achores, caries, enlargement of
the ruvula, defluxion of the hairs, ulceration of the head, pain in the
teeth. When some disease is about to fall upon the chest, it is usually
announced by the following symptoms : there are profuse sweats over
the whole body and particularly about the chest, the tongue ia
rough, expectoration saltish, bitter, or bilious, pains suddenly seiz-
ing the sides or shoulder-blades, frequent yawning, watchfulness,
oppressed respiration, thirst after sleep, despondency of mind, cold-
ness of the breast and arms, trembling of the hands. These symp-
toms may be relieved in the following manner : procure vomiting
after a moderate meal without medicine. Vomiting also when the
stomach is empty will answer well, to produce which first swallow
some small radishes, cresses, rocket, mustard, and purslain, and then
by drinking warm water procure vomiting. Upon those who neglect
these symptoms the following diseases are apt to supervene : pleu-
risy, peripneumony, melancholy, acute fevers, phrensy, lethargy,
ardent fevers attended with hiccough. When any disease is about
to attack the bowels, some of the following symptoms announce its
approach. In the first place, the belly is griped and disordered, the
food and drink seem bitter, heaviness of the knees» inability to
bend the loins, pains over the whole body unexpectedly occurring,
numbness of the legs, slight fever ; when any of these occur, it will
be proper to loosen the belly by a suitable diet without medicine.
There are many articles of this description which one may use with
safety, such as beets boiled with honied water, boiled garlic, mal-
lows, dock, the herb mercury, honied cakes ; for all these things
are laxative of the bowels. Or, if any of these symptoms increase,
mix bastard safifron with all these decoctions, for thereby they will
be rendered sweeter and less dangerous. The smooth cabbage
boiled in a large quantity of water is also beneficial ; this decoction
with honey and salt may be drank to the amount of about four
haeminse, or the water of chick-peas or tares boiled may be drank
in the same manner. Those who neglect the afore- mentioned symp-
toms are apt to be seized with the following affections : diarrhcea*
> dysentery, lienter}% ileus, ischiatic disease, tertian fever, gout, apo-
plexy, haemorrhoids, rheumatism. When any disease is about to
seize the bladder, the following symptoms are its usual precursors :
a sense of repletion after taking even a small quantity of food, fla-
tulence^ eructation, paleness of the whole body, deep sleep, urine
BOOK FIRST. 53
pale and passed with difficulty, swellings about the privy parts.
When any of these 83rmptoms appear, their safest cure will be by
aromatic diuretics. Thus the roots of fennel and parsley may be in-
fused in white fragrant wine, and drank every day when the sto-
mach is empty in the morning to the amount of two cyathi, with
water in whidi carrot, myrtle, or elecampane has been macerated
(you may use any of these you please, for all are useful) ; and the
infusion of chick-pease in water may be drank in like manner.
These symptoms when neglected are commonly followed by these
diseases : dropsy, enlargement of the spleen, pain of the liver, cal-
culus, inflammation of the kidneys, strangury, distention of the
belly. Regarding all these symptoms it may be remarked that
children ought to be treated with gentler remedies, and adults with
more active. I have now to give you an account of the seasons of
the year in which each of these complaints occur, and what things
ought to be taken and avoided. I begin with the winter solstice. —
Of the winter solstice, — ^This season disposes men to catarrhs and
defluxions, until the vernal equinox. It will be proper then to take
such things as are of a heating nature, drink wine little diluted or
drink pure wine, or of the decoction of marjoram, and indulge in
vcnery. From the winter solstice to the vernal equinox are ninety
days. Of the vernal equinox. — ^This season increases phlegm in
men, and the sweetish humours in the blood until the rising of the
pleiades. Use therefore juicy and acrid things, take labour, and
indulge in venery. To the rising of the pleiades are forty-six days.
Of the rising of the pleiades, — ^This season increases the bitter bile,
and bitter humours in men, imtil the summer solstice. Use therefore
all sweet things, laxatives of the belly, and indulge but sparingly
in venery. To the summer solstice are forty-five days. 0/ the
summer solstice. — This season increases the formation of black bile
in men, until the autumnal equinox. Use therefore cold water, and
every thing that is fragrant ; and do not indulge in venery, or do so
more sparingly than is generally directed regarding these matters.
To the autumnal equinox are ninety-three days. Of the autumnal
equinox, — ^This season increases phlegm and thin rheums in
men until the setting of the pleiades. Use therefore remedies for
removing rheums, have recourse to acrid and succulent things, take
no Tomits, and abstain from labour and venery. To the setting of
the pleiades are forty-five days. Of the setting of the pleiades, — ^This
season increases phlegm in men until the winter solstice. Take
therefore all sour things, drink as much as is agreeable of a weak
wine, use fat things, and labour strenuously. To the winter sol-
stice are forty-five days.
COMMENTARY
ON THE
FIRST BOOK
OF
PAULUS iEGINETA.
I.— ON THB COMPLAINTS OF PREGNANT WOMEN AND THE
REGIMEN PROPER FOR THEM.
Hippocrates says that, when pregnant women long to eat coals and earth,
the likeness of these things appears on the head of the child. De Superfata-
tionef c. 8. — Galen likewise believed in the influence of the imagination of
pregnant women on the foetus in tUero. Ad PUonem. This belief was very
ancient, for it appears to be countenanced by the Jewish historian. — See
Genesis xxx. 37 — 39. Traces of this opinion may be found in Hesiod ; and
distinct allusion to it is made in the Cynegetics of Oppian. Lib. i. 327.
The story in the Mihiopics of Heliodorus respecting Chariclea, the white
daughter of the black King and Queen of the Ethiopians, bespeaks the pre-
valence of the belief at the time when this celebrated romance was written.
My limits do not admit of my tracing the history of this singular notion in
modem times. I may mention, however, that it was adopted by the celer
brated Sir Everard Home, in a late publication, on the existence of nerves in
ike placenta, — Philosoph, Trans, for 1825. Andreas Laurentius gives an
interesting statement of ancient and modem opinions on this subject, de
Mirab. Strum. Sanit,
The bird pica is mentioned by name(ictrTa) in the Aves of Aristophanes. —
See also Schol. in Aristoph, in Fac. 496, and Vesp. 348. — ^Aristoteles, H. A.v ii.
4, and Plinius, H. N, z. 41. Hardouin concludes, from Pliny *s account of
it, that it was the magpie.
On the disease — See Galenus, Hygieine, de Causis Sympt. i. 7. — Aetius,
XTi. 10. — ^Theophanes Nonnus, c. 213. — Moschion de Morh, Mulier. c.
27. — Eros apud Gynacia — ^Alexander Aphrodisieus, ProbUmata lib. ii. p.
73. — Pseudo-Dioscorides, Euporist, ii. 16. Rhases, ContinenSf lib. xi.
Avicenna, lib. iii. fen. 21, tr. 2. — Haly Abbas, Theorica, vi. 17. — Serapion.
tr.iii. 22. — ^Alsaharavius, Pract. lib. xxv. §. 2. c. 8. It appears to be the
nalacia of Pliny, H. N. xxiii. 56.
56 COMMENTARY ON THE FIRST BOOK.
Moschion defines the pica to be an appetite for unusual food, which bap-
pens to pregnant women at some irregular period ; being attended with a
collection of depraved humours and nausea. It occurs, he says, most com-
monly in the second month, but sometimes earlier, and sometimes later.
He recommends a restricted diet at first, then wine, dry astringent food,
cataplasms of a repellent nature, and bodily motion.
But the account of the disease given by Galen and Aetius is the fullest.
They derive the name either from the bird, as mentioned above, or from ivy
{klttos), because, as ivy entwines itself about various plants, so does this ap-
petite in pregnant women fasten upon a variety of improper articles of food.
It is attended with languor of the stomach, nausea, and loathing of food, bring-
ing on vomiting of bile or phlegm, anxiety, and pains in the stomach. All
these symptoms arise, they say, from a sanguineous plethora, brought on by
a suppression ot the menstrual discharge. They, therefore, recommend a
restricted diet, and moderate exercise when the woman was accustomed to
it. When the humour which infests the stomach is of an acid, acrid, or
saltish nature, they direct to give draughts of tepid water, in order to en-
courage vomiting ; they forbid ail sweet things ; and recommend an old sub-
astringent wine. When there is a loathing of food, they advise to tempt the
appetite with a variety of savoury things. To those who have a desire for
eating earth, they particularly recommend starch. When the fluid which is
vomited is of a thick and viscid nature, they recommend to give pickles,
radishes, and oxymel, for an emetic. TTiey also particularly direct to apply
astringent cataplasms and plasters to the prscordia.
As the practice of the other authorities is conducted upon similar prin-
ciples, we shall only mention them very succinctly. For the depraved ap-
petite which longs for earth, Serapion recommends aromatic spices, such as
cardamom, cubebs, and the like. For the coatinued romiting, Alsaharavius
directs to apply over the stomach plasters, containing the oil of spikenard,
mastich, quinces, wormwood, and the like, or a vessel filled with hot water ;
to give pomegranate seeds to hold in the mouth ; to make the patient take
gentle exercise, and abstain from all sweet things.
Alexander Aphrodisieus accounts for the disease in much the same way as
Galen and Aetius. He says that, when the menstrual fluid is suppressed, a
determination of it takes place to the stomach, until the foetus becomes as
large as to consume it.
Pliny strongly commends citrons for the cure of the disease.
For the Edematous swellings of the feet and legs, most of the other autho-
rities concur with our author in recommending astringent applications. The
anthyllis mentioned by him, is supposed by Sprengel to have been the cres$a
cretica»
We shall conclude our commentary on this chapter with an outline of the
directions given by Aspasia for the managementof pregnant women. Women
who have conceived are to be guarded from frights, sorrow, and all violent
mental perturbation. They are to avoid gestation in carnages, severe exercise,
inordinate breathing, and blows about the loins ; also lifting heavy loads,
•dancing, and sitting on hard seats. Likewise all acrid and flatulent food^
strong clysters, and too much or too little food and drink are to be avoided^
All discharges of blood, whether from the nose or hemorrhoids, are dangerous
in the pregnant state. Moderate and wholesome food, gestation in a sedan,
gentle walking, soft friction, and the exercise of spinning, are proper. About
the eighth month, which is the most critical period of pregnancy, the diet is
to be more contracted, and the exercise increased . If the belly is constipated
owing to compression of the rectum, occasioned by the enlarged oterus,
laxative food is to be given, such as ptisan and mallows. In the ninth month
the regimen is to be of a relaxing nature, and for this purpose the tepid bath
COMMENTARY ON THB FIRST BOOK. 57
is to be frequently taken, for it has a great effect in rendering parturition
easy. Aetius, lib. xvi. 12.
Our author borrows part of this chapter from Oribasius, and abridges th«
rest from Galen and Aetius.
II. ON THB NURSE.
This chapter is taken from Oribasicis, Sj/nops. v. 2.
Aetius gives somewhat fuller directions. He says, the nurse ouzht not to be
younger than twenty, nor older than forty ; should be free from disease, and
have breasts neither too small nor too large. When the breasts are too large,
they contain more milk than the child can manage ; and part being retained
spoils, and proves injurious to the child, and even affects the health of tho
nurse. When too small, on the other hand, they do not contain a sufficient
supply of milk. Large nipples, he remarks, hurt the gums, and impede
deglutition ; whereas, when too smaAl, they cannot be got hold of. The
nurse, he says, should be chaste, sober, cleanly, and cheerful. Lib. iv. c. 4.
The directions given by the other authorities are very similar to our au-
thor's.— See, in particular, Rhases, ad mansor, iv. 30. — Avicenoa Cantica, —
Averrhoes in Cant. p. ii. tr. 1 . Avicenna says, the nurse ought to be from
25 to 35 years old. Averrhoes says, from 20 to 30.
It appears to have been a general practice among the Romans, after they
became luxurious and effeminate, for the ladies of noblemen to consign
the care of their infants to wet nurses. Tacitus, in his elegant dialogue de
Oratoribuiy inveighs against this practice, p. 105, Ed. Barker. — See also a
spirited declamation on this subject, by the philosopher, Phavorinus, in the
Nodes Attica of Aulus Gellius, lib. xii. c. 1. It is to be lamented that, at
the present time, this unnatural mode of bringing up children is far from
being uncommon. It is animadverted upon in very striking and forcible
terms by the well-known William Cobbett, in a sermon on the following
text: — ** Even the sea-monsters draw the breast; they give suck to their
young ones." Lamentations iv 3.
III. ON THE nurse's MTLK.
This chapter is taken from Oribasius, Si/nop. y. 3, and Aetius iv. 3.
The method of trying the quality of the milk here recommended is men-
tioned by Aetius, Barytius (ap. Geopon, xviii. 20.) Dioscorides, Avicenna,
Haly Abbas, and Alsaharavius. It is approved of by Smellie (Midwifery,
vol. i. p. 285), and by Van Swieten (§. 1354, Comment.) According to
Avicenna, a child ought not to be allowed to take suck oftener than twice or
thrice in the day.— See, in particular, Haly Abbas, Pract. i. 21, and Alsaha-
ravius, Pract. tr. xxx. c. 3.
IV. HOW TO CORRECT VITIATED MILK.
Aristotle forbids wet nurses to drink wine. It is the same thing, he
adds, whether the nurse or the child drink it. De Somno.
Oribasius, Aetius, and Avicenna, give similar directions to our author's.
They all permit nurses to take a moderate allowance of animal food and wine.
When the nurse has too little milk, Aetius recommends to make her drink
ale, (Ztfthus.) He also approves of sweet wine, gruels prepared with fennel,
or green dill boiled with ptisan. When the milk is thin, he directs to ab-
58 COIIIISNTART ON THB VIBST BOOK.
staiD from baths, and to take food of a nutritive quality, such as fine brea'l,
the legs of swine, tender birds, the flesh of kids, and sweet wine. When the
milk is thick, he recommends frequent baths, and an attenuant diet. When
the milk is excessive, he directs to diminish the quantity of tlie food, and to
give what is less nutritive, and to make discutient applications to the breasts,
such as a linen cloth wet in vinegar, and to wash them frequently with warm
salt water, or the decoction of myrtle.
Hippocrates forbids the nurse to take things of an acrid, saltish, acid, or crude
nature. He recommends fennel, cytisus, parsley, and the hot bath as a gene-
ral regimen to nurses. De Mulieb.
Haly Abbas gives similar directions. He properly recommends to pre-
vent the nurse from taking things of a pungent, sour, and bitter nature.
When the nurse's milk is deficient, he directs to give her the milk of cows
and goats, fennel, lettuce, parsley, and the like. Fract. i. 21.
y. ON THB NURTURB OF THE CHILD.
This chapter is taken from Oribasius, Synops. v. 5.
The practice of giving honey to new-bom children is similar to that of
tlie common people in Scotlano, who give sugar and water in these cases.
Galen, in like manner, approves of the honey. He directs to sprinkle the
body of a new-born child with salt ; and afterwards to rub it every day with
oil. After the milk diet is given up, the first food to be administered, he
says, should be bread, and a^rwards pulse and flesh. He forbids the use
of veine, because the temperament of a child is hot and humid. Hygiene.
Aetius recommends to bring up the child upon milk for twenty months.
Moschion says, from eighteen months to two years will be sufficient. Avicenna,
like our author, mentions two years. It is stated by Selden, that the Hebrew
women gave suck to their children for two years. This practice is enjoined
in the Koran. Aetius is not so strict in regard to regimen as Galen ; he
allows to vary the milk diet, by giving occasionally soft eggs, mead, or
sweet wine diluted with water. Lib. iv. c. 28.
Moschion, Averrhoes, and Avicenna, approve of exercising the child in a
cradle, and of lulling him with music. When the cord falls off, Avicenna
advises to sprinkle the part with the powder of burnt lead.
Averrhoes disapproves of sprinkling the child's body with salt, as recom-
mended by Galen, Colliget. lib. ii. c. 6. He agrees with Galen, however,
in condemning the use of wine. He directs to give the child exercise every
day, after exercise, friction, and after friction, the bath. He forbids the use
of the cold bath, however, because it retards the growth. When the child
does not sleep, Avicenna and Averrhoes recommend to give him poppy in
his food. CanticGf p. ii. tr. 1.
Haly Abbas directs, when there is any malformation of the head, to reduce
it to its proper shape, and bind it firm. Like Galen, he recommends to
sprinkle the body of a new-born child with salt and powdered roses, to har-
den the skin. He directs to give the child, for the first two days, sugar,
triturated with the oil of sesame. He recommends the frequent use of the
tepid bath. He properly directs, not to expose the child's eyes to the strong
lieht of day, nor to allow him to sleep in a strong sun, for fear of injuring
his eyes. When a child cries, it is the duty of the nurse, he says, to find out
the cause, as a child never cries except when something hurts it. The most
common causes, he adds, are, heat or cold, fleas or gnats, hunger or thirst, re-
tention of urine or of the faeces. For retention of the urine, he recommends
to give melon seed with julep both to the x^hild and the nurse ; and, when
the child's bowels are constipated^ he directs to give the nurse laxative herbs.
coif MINT ABT ON THB FIRBT BOOK. 59
oil of olives, prunes, and so forth. It is clear, therefore, that he was aware,
that a child may be operated upon by medicines given to the nurse. Dr.
Cullen considers this practice to be altogether nugatory ; but general ex-
perience, both in the human species and in the inferior animals, has proved
the contrary. Haly Abbas, Fract. i. 20.
The directions given by Alsaharavius are very similar. He remarks that
violent crying may occasion a descent of the bowels.
Syrasis, one of the commentators on Avicenna, recommends the tepid bath
for young children, and food after it. He directs to exercise the child before
putting him into the bath.
From what we have stated, it will be seen, that the ancient physicians did
not approve of the cold regimen, absurdlyproposed by certain modem phi-
losophers as the most proper for infants. Tiiey also very properly forbade the
use of wine, a practice strongly reprobated by the celebrated Dr. Waters
house of America. Public Lecture, containing Cauiiont to Young Penom
concerning Healthy p. 29.
VI. ON THB BXANTHBIIATA, OB BBUPTI0N8 OF INFANCY.
This chapter is taken ^m Oribasius, Synoptiiy v. 6. See also Aetius,
lib. iv. 21. The exanthemata here referred to appear, properly speaking, to
be the ttropkuli of Dr. Willan, but the ancients used the term rather vaguely
for several eruptive diseases. See book 4th. The exanthemata appear to
be the '^ pustulae parvs'* of Eros, apud Gynaeia, p. 59. For the Arabians,
see in particular Haly Abbas, Fract, i. 20. — ^Avicenna, lib. i. f. 3. d. 1. —
Alsaharavius, tr. xxvi. c. 7 and 8. Alsaharavius describes two cutaneous
complaints of infency by the names of Alseafa and Alkaba, The former he
describes as consisting of pustules, which affect the heads of infants, and
sometimes the face. They are attended, he says, with a constant itching,
and occasion erosion. This appears to be the porrigo larvalis of Drs. Willan
and Bateman. He directs to shave the head, and to apply to it first a leaf
of blite (bleta vel betal) and afterwards an ointment composed of spuma
argenti, ceruse, and lye with rose oil and wax. The Alkaba is said to be of
the same nature, only that the fluid which runs ftx>m the pustules resembles
honey. This, therefore, must be the porrigo favosa. He directs to wash the
head frequently with a lotion made from maijoram, mint, or centaury ; and
then to apply an ointment composed of spuma argenti, ceruse, Armenian
bole, sulphur, almonds, and quicksilver; and also liniments of rose-oil and
vinegar, with the free use of the bath. As Dr. Willan remarks, he has de-
scribed the strophuli by the name of pustulae (bothor), tr. xxvi. c. 25.
He says of them : *^ Alise sunt albs, alise rubee, aliae nigrae, alise magns, alis
parvs et multee et panes?, alis fortis et acuti doloris, et mortiferce,'* &c.
It appears, therefore, that he applies the term in a very lax signification.
Rhases describes the exanthemata by the name of vesica. He recom-
mends to give at the commencement medicines for expelling the morbific
superfluity firom the inner parts, such as the decoction of dates or figs, with
fennel water. When the eruption is fiurly come out, he recommends baths
medicated with roses, myrtles, and the like ; after which, the child is to be
robbed with the oil of roses or of violets. De .^ritvd, Infantium, c. 19.
Lanfrancus, and the other medical authorities of that age, describe them by
the name of sopAa^t.
VII.— ON THB COUOH AND DBFLUXION OF INFANTS.
See Oribasius, Synop. v. 7, and Aetius, iv. 18. Aetius recommends
various lohochs or linctus. One of them consists of pine kernels, almonds,
linseed, liquorice juice, and honey.
60 COMMBNTART ON THE FIB8T BOOK.
Emetics and demulcents, such as gum arable and liquorice, are the reme-
dies recommended by Avicenna, lib. i. fen. 3. doct. 1.
Haly Abbas approves of lohochs containing almonds, honey, &c. Pract.
i. 20. Alsaharavius recommends various demulcents, and an electuary con-
taining poppy seed, tragacanth, and the seeds of citrons, to be taken in a
decoction of Sebesten plums. lie also directs to produce vomiting, by mak-
ing the patient swallow copious draughts of honied water. Tr. xxvi. c. 24.
Hhases recommends nearly the same remedies, de Morbis Infant, c. 18.
VIII. — ON PRURITUS.
See Galenus, Ht/g. lib. v. — Oribasius, Synop. v. 8. — Avicenna, lib. i.
fen. 3. d. 1. — Haly Abbas, Pract. i. 20. — Rhases de Morb. Infant, c. 19. —
Alsaharavius, Pract, xxvi. 25.
The account given by Oribasius is similar to our author*s. Synop. v. 8.
Alsaharavius properly directs to pay attention to correct the acrimony of
the nurse's milk ; to wash the child with decoctions of roses, myrtle leaves,
and the like ; if the pustules are of a dry nature, to rub them with oil of
sesame or of violets ; and, if humid, with an ointment made of wax, litharge,
and rose oil.
Rhases directs to make the nurse abstain from sweet and salt things, as
they inflame the blood ; and to put the child, into a bath medicated with
mallows, pearl-barley, fenugreek, gourds, &c.
Avicenna and Haly Abbas treat the complaint upon similar principles.
IX.— ON DENTITION.
See in particular Oribasius, Synop. v. 9, and Aetius, iv. 9. Ilippoci-ates
and Aetius recommend a jasper amulet. Hippocrates remarks that pains,
restlessness, and convulsions are apt to come on at the time of dentition, if
the child be plethoric, and his belly constipated. AphoriSy cum Comment.
Galeni,
Moschion directs to rub the gums of the child, after the fifth month, with
sweet oil, the fresh grease of a hen, the brain of a hare, and lastly with
boiled honey. When inflammation supervenes afterwards, he recommends
fumigations and cataplasms, and directs to restrict the food and drink of the
nurse. C. 119.
The directions given by Avicenna are similar to those of Moschion, lib. i.
fen. 3. doct. 1. Alsaharavius properly states that the best way to avoid dif-
ficult dentition is to guard against corruption of the food and drink, and to
abstain from emetics, acids, figs, &c. To remove the painful symptoms
attendant on dentition, he directs to rub the gums with olive oil, honey in
which aloes and gum arabic have been boiled, and the like ; to wrap the head
in soft wool, and to pour tepid water upon it. Pract. xxxvi. 19.
The treatment recommended by the other authorities is very similar. See
in j^rticular Rhases, iii. c. 13.
The only ancient authors who make mention of scarification of the gums
as a remedy for painful dentition are, Marcellus Sideta (Mcdicina ex Pisci-
bus) and Pliny, H. N, xxxii. 26. Both direct to do it with the sting of the
Pastinaca Marina.
Ambrose Par^ recommends to open the gums with a lancet in extreme
cases, but mentions the practice in such terms as shows that it was not com-
mon in his time.
Sprengel gives the history of this simple operation. Hist, de la Med.
§ xviii. c. 17.
COMMKNTAUr ON THB FIRST BOOK. 6L
X. — ON APHTHJB, OR THB THRUSH.
The aphtha appears to be the otcedo of Isidorasy Orig, iv. 8.
Our author copies from Oribasius, Synop, ▼. 10. See also Aetius, viii.
39. Aetius borrows his account from Graleo, who is very iiiU upon the
treatment of aphthee. He remarks, that recent superficial ulcers are easily
cui-ed, but that such as spread and are of a gangrenous nature are very dan-
gerous. He gives, at great length, directions for the composition of applic^-
tionsy suited to every modification of the complaint. When the pustules are
red, he directs to use washes of a moderately astringent and cooling nature ;
if yellowish, the same, but somewhat more refrigerant ; if whitish and pitui-
tons, detergents are to be used ; and, if black, the most powerful discutients.
For simple cases of the aphthae infantium, he merely recommends the flowers
of roses with honied water. Most of his remedies are astringents. De Med,
sec. Loc. lib. vi. In another work, he says that aphthae are occasioned by
the acrimony of the milk, and are to be cured with astringents. Comment,
in III, Popul,
Avicenna recommends at first washes prepared from the vegetable acids,
and afterwards astringents, such as galls, sumach, balaustine, &c. Lib.
i. fen. 3. doct. 1. See also Haly Abbas, Pract, i. 20.
Alsaharavius states that aphthae generally arise from the sharpness of the
milk. His general treatment consists in regulating the diet of the nurse, and
using washes principally of an astringent nature for the child's mouth.
When they are very painful, he directs to add to the washes the juice of
lettuce, endive, and the like. When they are whitish, he recommends to use
a powder consisting of myrtle, saffron, and sugar. Tr. xxvi. 20. Rhases'
treatment is quite similar, de Morbii Infantium, c. 14.
The author of the Euporiston, which has been falsely ascribed to Dios-
corides, recommends certain applications of a strongly escharotic nature,
such as the following: Of arsenic, p. i.; of burnt paper, p. iii.; or this, of
sandarach and rose-oil equal parts. Euporist, i. 82.
Psellus enumerates two kinds of aphthae, namely, the white and the red ;
the fonner, he says, is mild, the latter very dangerous. Poema Medicum,
XI. ON BZCORIATIONS OF THB THIGHS.
See in particular Oribasius, Synop, v. 11. — Aetius, iv. 24, and Avicenna,
lib. i. fen. 3. doct. 1. All recommend nearly the same astringent applications
for the Intertrigo of infants.
XII. ON DI8CHAR0BS PROM THB BARS.
Oribasius, Aetius, Avicenna, and Haly Abbas, recommend the same
treatment, which would seem to be very proper. Alsaharavius recommends
to apply wor)l soaked in a solution of alum, and to use injections, consisting
of solutions of nitfe (soda) in vinegar. Rhases makes mention of nearly the
same applications, de Morb. Infant, c. 9.
XIII. — ON SIRIASIS.
See Oribasius, iSynop. v. 13. — Aetius, lib. iv. c. 13. — Avicenna, lib. i.
fen. 3. doct.. 1, — Haly Abbas^ Pract, i. 20. Alsaharavius, Pract, xxvi. 9.
62 COMMENTARY ON THE FIRST BOOK.
Khases,(ie Morb, Infant, c. 5. — ^Pseudo-Dioscorides, Euporist. i. 9.— Alex-
ander Aphrodisieus, ProbUm i. 98. — Plinius, H, N. xxxii. 48.
Aetius and Avicenna agree in describing it as an inflammation and swell-
ing of the brain and its membranes, so as to occasion a hollow at the bregma,
and as being attended with ardent fever. The account given by the others is
very similar. All recommend cooling and astringent applications to the part.
According to Alexander Aphrodisieus, children are most subject to this affec-
tion, especially in the summer season ; for which he attempts to assign the
reason. He describes it as an inflammation of the membranes of the brain.
The author of the Euporiston recommends the juices of various cooling herbs,
as local applications. Pliny represents the heat of it as excessive. He says,
'' Siriasesque intotium spongia frigida crebro humefectata, rana inversa adal-
ligata efficacissime sanet, quam aridam inveniri affirmant."
Sprengel, treating of Paulus, says, ** II decrit fort au long Tinflammation
de la tete connue depuis long-temps sous le nom de Siriasis.'' Hist, de la
Med, § vi. c. 3,
XIV. — ON THE RBOIMEN OF INFANCY AND OF THE SUCCEEDING
AGES, UNTIL MANHOOD.
These simple but judicious directions, respecting the regimen of the differ-
ent periods orlife, are taken from Oribe^ius, Synap, v. 14. — or from Aetius,
iv. 29. Many of them are borrowed originally from Galen, Hyg. lib. i.
Similar directions are given at great length by Haly Abbas. He positively
prohibits children flrom taking wine. He insists that wine not only proves
prejudicial to health, but also deteriorates the morals, Pract. i. 22. Alsa-
haravius agrees with him in proscribing wine to children, Theor. xiii. 2.
Avicenna makes very judicious observations on this subject, but the greater
part of them are taken nrom Galen. He insists with becoming earnestness
on the propriety of attending to the regulation of the passions of the child, as
being conducive to his health as well as to his morals. As soon as the boy
is roused from sleep he is to be bathed ; then he is to be allowed to play for
an hour ; afterwards, he is to get something to eat, and then is to be allowed
more play. Afterwards he is to be bathed ; then he is to take food ; and, if
possible, he is to be prohibited from drinking water immediately after a meal,
as it has a tendency to make unconcocted chyle be distributed over the body.
When six years old, he is to be consigned to the care of a teacher, but he is
not to be compelled to remain constantly in school. And here, by the way,
I will digress to introduce the sentiments of Quintilian, the great Roman
authority, on all matters relating to education : ** Nee sum adeo imprudens
aetatum, ut instandum teneris protinus acerb^ putem, exigendamque plenam
operam. Nam id in primis cavere oportebit, ne studia qui amare nondum
potest, oderit, et amaritudinem semel prsceptam, etiam ultra rudes annos re-
rormidet.'' Inst. Orat. lib. i. Avicenna goes on to state that, at the age he
has then reached, he is to be more sparingly bathed, and that his exercise
is to be multiplied before eating. Like most of the ancient authorities, he
forbids to allow the child wine. Thus, he adds, is the regimen of the child
to be regulated until he reach the age of fourteen. Lib. i. fen. doct. i. c. 4.
Averrhoes gives very sensible directions on this subject. He forbids the
use of wine and ales until manhood. ColUget. lib. vi. 6.
XV. ON THE PREPARATORY FRICTION.
A MORE circumstantial account of the mode ofpreparing the body for gym-
nastic exercises is given by Oribasius, Med. Collect, vi. 13: It is .taken,
GOMMSNTART ON THB FIRST BOOK. 68
however, from Galen's 2d book of Hygiene. See a similar account in Actios,
lii. 1. and Avicenna, lib. 1. fen. 3, doct. 2. The object of it, according to
Alexander Aphrodisieus, was to soften the parts so that they might not be
niptured. Frob, i. 119. To rub the body with oil was a general practice of
the ancients before strong exercises of every kind. Hence Horace cbarac*
terises an inactive person by his dread of oil : ** Cur olivum sanguine viper*
ino cautius vitat r — that is to say, as his commentator Acron explains it,
^ Cur Titat olivum, id est oleum, quo unctus tutius natet et luctetur ?** The
poet alludes to the practice in another place : ^ Ter uncti transnanto Tiberim.'^
It appears from Martial that a composition of oil and wax, called eeromoy was
sometimes used for this purpose.
" Vara nee ii^jecto ceromate brachia tendis.*' — Lib, vii. Epiffr. 32.
According to Thucydides, the Lacedemonians were the first who rubbed
their bodies with oil before wrestling. Lib. i. c. 1 . Pliny mentions the use
of oil before the gymnastic exercises as a luxury introduced by the Greeks.
It appears from him that cheap aromatics were sometimes added to the oil.
He mrther relates, that some barbarous nations used butter instead of oil. H.
AT.xi. 41.
Athenseus mentions that Atitiochus Epiphanes supplied the wrestlers at
Daphne with oil of saffron, of marjoram, and the like. Deipn. lib. v.
Lucian makes Solon say to Anacharsis that oil produces the same effect
upon the living body as upon leather, softening it, and rendering it stronger
and less apt to break. Anacharsis,
Mercurialis gives a learned disquisition on the preparatory friction, in his
work, de Arte Gt/mnastica, lib. i. 8. Baccius approves very much of the
unction with oil previous to going into the bath. t)e Thermis, lib. iii. The
Roman emperors, and other luxurious persons, often made use of perfumed
ointments instead of oil. See Suetonius, in Vita Caligiday Lampridius, in
Vita Heliogabali. It would appear that under the empire the people of
Rome were supplied gratuitously with oil in their public baths. V. Lamp,
c. 24, and Burman, de V, R, c. iii.
XVI.-^ON BXERCI8B8.
The remarks of our author on the effects of exercise are exceedingly per-
tinent and comprehensive. See, in like manner, Aetius, iii. 2, and Oribasius,
Med. Collect, vi. 11. But Galen is the great authority on this subject, which
he treats of very folly and philosophically, in the 2d book of his Hygiene,
He agrees entirely with Hippocrates, in stating that the proper time for exer-
cise is before a meal, because, the excrementitious superfluities being thereby
evacuated, the body is in a fit condition for receiving a new supply. He
explains, however, afterwards, that it is after the digestion and distribution of
a preceding meal have been accomplished that exercise will be most proper.
Averrhoes, in like manner, insists upon this rule. Collect, § ii. c. 2. Dr.
Paris, by the way, states that this is the proper season for exercise. Al-
tbou^ he disapproves of exercise immediately after a meal, he does not
approve of taking it when the stomach is empty. — (On Diet,)
According to Haly Abbas, exercise is useful for three purposes : 1 . For
rousing the innate or natural heat, whereby the processes of digestion and
distribution are accelerated. 2. For opening the pores of the body, and
evacuating its superfluities. 3. For strengthening and rousing the animal
actions, by the friction it occasions. Theor, v. 2. Avicenna gives nearly
the same enumeration of the good effects of exercise. Haly Abbas forbids
to take exercise immediately after dinner. He adds, that exercise taken
64 COMMENTARY ON THE flRST BOOK.
immediately after a meal makes the food descend to the intestines, where it
is absorbed by the veins before it is properly concocted, and thereby the
liver becomes loaded vrith crudities. Pract^ i. 3.
Alsaharavius directs to take exercise before a meal, but advises not to con-
tinue it after one feels fatigued and languid. Theor, tr. ii. c. 2. The same
rule is distinctly laid down by Rhases, Continens, lib. xxxiii. Dr. Paris, in
like manner,, directs not to carry exercise the length of occasioning fatigue.
He mentions that he had known many valetudinarians who, seeking to im-
prove the state of their stomachs, by taking exercise before a meal, had de-
feated their end, by carrying it tlie length of fatiguing and weakening the
powers of the system. — (On Diet.)
It appears that, instead of taking exercise after food,^ the ancients were in
the practice of indulging in a short sleep after their dinner or mid-day meal.
See Plautus, MostelL ac. iii. sc. 2. 1. 8, and the note of Meursius. Ed.
Gronov. Homer says that it is beneficial to old men to indulge in sleep
after the bath and taking food. V. Galen. Hi/g, lib. 1.
Plutarch mentions that Cicero was cured of debility of the stomach by
taking moderate exercises. In vita Ciceronis.
It was one of the extravagant opinions of the otherwise justly<^elebrated
Erasistratus, that exercise is not at all necessary for the health of the animal
frame.
Hieronymus Mercurialis gives many pertinent remarks on the ancient
exercises. De Art. Gymnastica^ lib. iv. See also Baccius, de ThermiSf lib.
vi. and Vossius, de Natura Artium, lib. i.
XVII. ON THE KINDS OF EXERCISE.
We shall now give a brief account of the ancient exercises, some of which
are altogether omitted by our author.
The a-Kiofrnxui is thus explained by Cornarius : " Porro a-Kiofiaxuip acci-
pio umi)ratilem pugnam, quk quis privatim . dpmi aut sub umbra, non in
propatulo se exercet, ac veluti prsparat ad justam pugnam publice facien-
aam." Nota in Paul. .^in. h. I. This account, however, does not agree
with that of Oribasius, who describes it as a mock encounter at boxing and
jumping with one's own shadow. Med. Collect, vi. 29. It is thus described
in the Latin translation of Avicenna : '* £t ex eis est, insequi umbram suam,
ut ipsam percutiat in capite, et manus ad invicem percutere.'' Lib. i. fen. 3.
doct. 2. c. 2. It is mentioned in this sense by Plato, de Legibus, lib. vii. ;
and by Plutarch, Frohl. Conviv. lib. vii. Juvenal probably alludes to this
sport. Sat. vi. 246. I have therefore translated it, " fighting with one's
own shadow."
The aKpoxfipio-fios is thus described by Scaliger : '' Est autem aKpoxfip^C^uf
luctae pars, cum primoribus tantumdigitis insertis roboris faciunt pei-iculum."
PoeticeSy lib. i. c. 22. Suidas explains it thus : XafAfiopofuvos yap oKp&p rap
X€ip&v Tov carrayovurrov tiCKa^ Kui ov nporepov ^(jnei irpiv diarooiTO oTroyo-
peva-avTos. The term occurs in Aristotle, Eth. Nicom. iii. 1. See also,
Athenseus, Deipnos. iv. 13. It is called oKpoxtipuns by Hippocrates, De
Diata.
The exercise with the K&pvKOSf or leather bag, is described by Oribasius in
the following manner : A bag filled with flour or sand was suspended from
the top of the house, on a level with the navel ; it was then pushed forwards
with the hands to the extremity of the rope, and, as it recoiled, the person
performing the exercise retreated backwards, so as to escape from it. Med.
Collect, vi. 33. This exercise is mentioned by Hippocrates, De Diwta, lib.
ii. Cornarius confounds it with the /o//is of the Romans; but Mercurialis
COMMBNTAK7 ON THE FIRST BOOK. Gj
clearly shows that they were quite different. The follis was a leather ball,
inflated with air: such is the description of it by Ccelius Aurelianus, *' Follis
erat piia magna ex alutli confecta, soloque vento repleta.'' Martial repre-
sents it as a becoming exercise for boys or old men :
Ite procnl juvenes, mitis mihi conveoit tetas,
FoUe deoet pueros ludere, foUe senes. — Epiyr, ziv. 45.
They were different from the pila magna and parva. These are minutt ly
described by Oribasius, Med. Collect, vi. 32. See also Horace, Sat. ii. 2, and
Martial, EpigrAy. 15. See a most learned and accurate account of all these
sports in Mercurialis, de Arte Gymnaitkay lib. ii. c. 4. Galen wrote a trea-
tise on the exercise of the parva pila. To this class we may refer the pitch-
ing of a »ton€, which is mentioned by Avicenna.
Our author has neglected to make mention of the halteres in this place,
but recommends the exercise for the cure of elephantiasis, lib. iv. c. 1 . The
exercise with them is thus described by Potter : " The exercise of leaping
they sometimes performed with weights upon their heads or shoulders, some-
times carrying them in their hands ; these were called oXr^pcr, which, though
now and then of different figures, yet, as Pausanias reports, were usually of
an oval form, and made with holes, or else covered with thongs, through
which the contenders put their fingers." Antiquities of Greece, c. 20. Mer-
corialis describes them as masses or weights of different materials, and of
such a size as that they could be held in the hands. Ropes, too, he adds,
were often fastened to them, to hold with. De Arte Gymnasticuy ii. 12.
The Pythagoreans were fond of this exercise. Iambi ichus, de Vita Pytha-
gora, c. 21.
The funambulatio consisted merely in scaling ropes, which, as we may
suppose, was done in various ways. See Mercurialis, iii. 5, and Baccius,
de ThermiSf viii. 7.
The €«arXe^pi^€iv, as Galen and Avicenna explain, consisted in running
round the plethrum, or sixth part of the stadium, and always contracting the
circle of one's course, until one stopt in the middle. The irirvXt^ctv, as the
same authors explain, consisted in walking upon one*s toes, and tossing one*s
hands backwards and forwards.
The cricilasia appears to have been a large hoop, or circle, which was rol-
led on the ground. Even Mercurialis admits the obscurity of Oribasius's
description of it, Med. Collect, vi. 26.
The petaurum was a seat suspended by ropes, in which seat the person
taking the exercise sat, and was tossed about by assistants. It is mentioned
by Juvenal, Sat. xiv. and Martial, Epigr. xi. 22. «
Antyllus thus describes the effects of equitation on the human frame : '' It
strengtiiens the body, especially the stomach, more than any other mode of
exercise ; it clears the organs of the senses, and renders them more acute ,*
but it is most inimical to the thorax.*' Oribasius, Med. Collect, vi. 24.
Pliny (H. N. xxviii. 4.) and Aetius agree with Antyllus as to the good
effects of equitation on the stomach. Hippocrates and Ccelius Aurelianus
state that equitation is hurtful in disease of the hip-joint. All agree that
riding on horseback is hurtful to diseases of the chest.
Of oi&poy or gestation, there were various modes. That in a carriage was
very ancient, and is often mentioned by the medical authors. It appears
from Pliny (H. N. xvi. 42.) that carriages were generally made of fir, and
that the axles were of ilex, mountain ash, or elm. Sometimes, however, the
whole chariot was adorned with gold and silver, (Pliny, H. N. xxiv. 17.)
They appear to have been often covered in with skins, (Plutarch, Prob.
Roman.) They were generally drawn by horses or mules, sometimed by
oxen, and occasionally by slaves. Th6y were so constructed that a person
F
C6 COMMENTARY ON THB FIRST BOOK.
could either sit or lie, according to pleasure, (Galen. Ht/g.) At first, accord-
ing to Pliny, they had only two wheels ; the Phrygians, he says, added two
more ; and Hippocrates mentions, that the Scythians introduced the use of
six-wheeled carriages. The sedan and chair are often mentioned by the
Latin poets, as well as by the medical writers. It is sufficient for our purpose
to state, that they were so constructed, that one could either sit or lie in them.
They sometimes had windows, formed from the lapis specularis. Juvenal,
Sat. iv. 21. Navigation, or sailing in ships and boats, is often mentioned by
ancient authors as a remedial measure. It was practised on the sea, or in
rivers. According to Aetius, gestation in general ventilates the natural beat,
produces excitement, dispels collected humours, strengthens the frame, and
rouses the actions when m an indolent state. Lib. iii. c. 6. Celsus has art
interesting chapter on gestation. The following rule for the application of it
is very judicious : ^* Gestatio quoque longis et jam inclinatis morbis aptissi-
ma est; utilisque est et iis corporibus quae jam ex toto febre carent, sed adhuc
exerceri per se non possunt ; et iis quibus lentae morborum reliquiae rema-
nent, neque aliter eliduntur." Upon the whole, he holds it to be a doubtful
practice in ardent fever, although sanctioned by the authority of Asclepiades :
at all events, he insists that gestation is improper when there is any local
pain or swelling. After characterising the different modes of gestation, be
remarks respecting them: — ^** Levia quidem genera exercitationis infirmis
conveniunt : valentiora vero iis qui jam pluribus diebus febre liberati sunt-;
aut iis, qui gravium morborum initia sic sentiunt, ut adhuc febre vacent,
quod et in tabe, et in stomachi vitiis, et cum aqua cutem subiit, et interdum
in regio raorbo fit ; aut ubi quidam morbi, qualis comitialis, qualis insania
est, sine febre, quamvis diu, manent.'' Lib. ii. c. 15.
Galen eulogises hunting as being an excellent exercise to the body, and an
agreeable recreation to the mind. He says, that by the mental excitement
which it produces, many have been cured of dangerous diseases. X)c parva
pita. Rhases mentions, that during the prevalence of a certain pestilential
epidemic, it was observed, that huntsmen were the only class of people who
escaped its contagion. Continens, lib. iii. The ancients have transmitted
to us many elegant treatises, both in prose and in verse, on this delightful
recreation. Those of Xenophon, Oppian, Gratius, and Nemesianus, will be
found particularly interesting. The younger Pliny attributes his recovery
from a certain complaint, to the exercise of hunting. Epkt. lib. v. 6.
The occupation of fishings according to Plato, produces neither mental
nor bodily excitement. In Sophisfa. Galen and Avicenna briefly mention
it, as an exercise which may tend to the preservation of health ; but neither
of them appears to have attached much importance to it. The poet Oppian,
however, nas celebrated the pleasures and dangers of fishing, with all the
enthusiasm of an Isaac .Walton, or a Washington Irving.
Oribasius states, that swimming tends to warm, strengthen, and attenuate
the body. He says, that swimming in the sea is particularly applicable in
cases of dropsy, eruptive diseases of the skin, and elephantiasis. It is apt,
however, he adds, to prove injurious to the head, and also to the nerves when
too long continued. We have mentioned in the 15ih Chapter, that the an-
cients got their bodies rubbed with oil before going into the water. Celsus
gives nearly the same account of it, as a remedy for the cure of diseases, as
Oribasius.
Jumping and dancings according to Oribasius, occasion a determination
downwards, and hence, they may prove useful in cases of amenorrhea. Med.
Collect, vi. 31. It appears from a case related in a work attributed to Hip-
pocrates, that jumping was had recourse to, to procure abortion. Dertnt.
pueri. The pyrrhic dance of the ancients was particularly celebrated. It
was performed by armed men. — See Vossius, de naf. art. lib. i.
COmilNTABT ON THB FIRST BOOK. G7
On the Apotherapia or Restorative process.—- See Galenus, Hyg. iii. Ori-
basius, Mea. Collect, vi. 16, and Avicenna, lib. i. Fen. 3. D. 2. It consisted
simply in mbbing the body softly and moderately with oil. According to
Galen, the object of it was to relieve the feelings of lassitude, and prevent
any l>ad effects from the exercise. Mercurialis states, that when applied after
the bath, it was with the intention of preventing the humidity from being
dissipated. Odoriferous ointments and powders were sometimes used, in-
stead of the oil. De arte gymnasticOf lib. i.
XVIII. ON THB MODBS OF FBICTION.
HiPPOCRATEs's brief, but comprehensive rules for the application of fric-
tion, are tbus given in the language of Celsus : — " Hippocrates dixit, fric-
tione, si vehemens sit, durari corpus ; si lenis, molliri ; si multa, mioui ;
si modica, impleri.'' Celsus adds, that according to circumstances, the body
may be braced by it, if relaxed ; may be softened, if indurated ; may have its
superfluities expelled, if loaded with plethora, and have nourishment attracted
to it, if emaciated. He remarks, that it is mostly applicable in the decline of
a disease. His other directions for the application of it are very apposite.
Lib. ii. c. 14.
Pliny delivers the rules of Hippocrates in nearly the same words as Celsus.
H. N, xxviii. 14.
Our author's account of friction is taken from Oribasius. Med. Collect.
lib. vi. or from Aetius, lib. iii. All, however, are indebted to Galen, who
handles the subject most scientifically. Hyg. lib. ii. *
Similar directions are given by Avicenna. Lib. i. fen. 3. Doct. 2. and
by Haly Abbas. Theor. v. 12. Averrhoes gives the sum of the directions
liud down by Galen and the other authorities. Strong friction, he says,
braces and hardens the body ; weak, rarifies and softens ; moderate, operates
in an intermediate degree. Besides, he adds, hard friction diminishes obe-
sity ; moderate, on the other hand, tends to remove emaciation. Collect, ii. 3.
It was a general practice of the ancients to have recourse to friction in the
momiog aim evening. Oribasius has many excellent observations on this
practice, u. s.
Dr. Paris remarks, '' the ancients are well known to have held friction in
high estimation, not only in the cure, but for the prevention of diseases. The
modems have unwisely suffered the practice to rail into disuse.'* On Diety
p. 362.
XIX. ON YOCITBBATION, OB THB EXBBCISB OF THB VOICE.
Th£Se remarks of our author are very pertinent; but Oribasius has given
amoreoomprehensive view of the subject, from the works of Antyllus. He
thus describes the mode of performing vociferation. The bowels being
eracoated, the person's body is to be first rubbed, and then the inferior parts
and the fi^ are to be sponged with water : He is to begin talking, at first, in
t moderate tone, while at the same time he walks about, and afterwards
straining his voice to a louder tone,. he is to repeat certain verses. Med.
Collect, lib. vi.
Plutarch gives nearly the same account of it. He commends vociferation
as giving strength to the internal parts, increasing the vital heat, purifying
the veins, attenuating the blood, and dispelling the humours. He cautions,
however, net to strain the voice to too great a pitch, lest it occasion rupture
of any of the vessels. De sanitate tuendd.
f2
68 COMMENTARY ON THE FIRST BOOK.
Vociferation, according to Aetius, is an exercise of the chest and tl>e organs
of speech, improving the vital heat ; attenuating and strengthening the solid
parts of the body. He recommends it for the cure of asthma, orthopnsa,
phthisical, and chronic pains of the chest, or aposthemes ^hen they burst;
also, in tertian intermittents, and affections of the stomach attended with vo-
miting. It is unsuitable, he says, in complaints of the head. Lib. iii. c. 5.
Celsus recommends loud reading for curing weakness of the stomach.
Ijb. i.8.
Galen scarcely takes any notice of vociferation, except, that in one place,
he states, that it exercises the chest and lungs. De sanitate tuenda. Lib.
ii. 11.
Avicenna, in giving an account of vociferation, follows Aetius. He says,
that it exercises the parts about the mouth and chest ; and hence, that it im-
proves the complexion. He likewise cautions not to prolong loud enuncia-
tion, lest it occasion a rupture of the vessels. He directs to begin moderate,
and then strain the voice gradually, and afterwards to allow it to sink by de-
grees. Lib. i. fen. 3. doct. 2.
XX. — ON LASSITUDE FROM EXERCISES.
There is a short treatise on this subject^ among the minor works of Theo-
pbrastus. He states, that, as the excess of motion in this case has produced
a preternatural dryness of the body, the indication of cure is to humectate,
that is to say, to dilute by baths and drinks. The work contains many in-
genious observations; but our limits do not admit of our giving a proper out-
line of it.
Our author copies from Oribasius, Synops. v. 15. — See also, Aetius, iv. 55.
el seq. They all, however, are indebted to Galen, de sanit, tuend. Lib. iii.
c. 7. The ulcerose lassitude, he says, arises from a collection of excremen-
titious superfluities, which are produced by the melting of fat and muscle, lu
the second species, called the tensive, there is no collection of humours, but
the muscular fibres are excessively stretched. The third species, or the inflam-
roative, is characterised by a sensation, as if the parts affected were bruised
or inflamed, and happens when the muscles being excessively heated, attract
the superfluities from the surrounding parts. From the pain being deep
seated, is has been called ostalgia. He adds a fourth species, being a case
somewhat different from all those we have been describing. It is the contrary
state to that of the inflammative, the body appearing squalid and contracted.
The first case, as it is connected with redundance of humours, is to be cured by
discutients ; and hence the proper remedy for it, is much friction, with
emollient oils, wholly devoid of astringency. He also approves of the gentle
exercise, called the restorative. The second species, or the tensive, is to be
cured by gentle friction, with emollient oils heated in the sun ; by complete
quietude, and the frequent repetition of the tepid bath. In particular, unction
with oil is proper. The third species, as it is occasioned by violent motions,
and is attended with excruciating pains, is to be cured by the gentlest friction,
with the most emollient oils ; by the most perfect rest, and the tepid bath.
The fourth species, characterised by squalor and constriction of the skin, is to
be treated by the hot bath, to warm and invigorate the skin, then soft and slow
molions and friction ; and then again by the hot bath. But, he adds, the
patient must straightway leave the cistern of the hot bath, and plunge into
that of the cold. He directs not to remain long in it. The diet in all these
cases, is to be restricted and cooling, especially in the inflammative.
As all the subsequent authorities, whether Greek or Arabian, adopt the
views of Galen, I need not enter into thedetail of their plans of treatment.
COMMBNTART ON THE FIB8T BOOK. 69
See Psellus, Opus Medicum. — Ai^icenna, lib. i. fen. 3. doct. 2. — Rhases,
Continens, xxxi. — ^Alsaharavius, Pract. xxxi. 11.— Averrhoes, CoUiget, vi. 8.
Collect, ii. 15. The bath, emollient friction, diluent food, and quietude, are
the remedies generally recommended by all the ancient authorities ; and they
are directed with a nice discrimination that cannot be too much admiredf.
Syrasis, one of Ayicenna's expositors, also gives the rules of treatment with
great judgment.
Prosper Alpinus, gives a fair account of the ancient doctrines on this sub-
ject. Meth, Med. iv. 16. and de prcttag. vita et morte,\\. 21.
XXI. ON CONSTRICTION OP THE SKIN.
This chapter is taken from Oribasius, St/nops. v. 16. But a somewhat
fuller account is given by Galen. Hyg* iii* 10. Like our author, he states,
that this affection is occasioned, either by a collection of thick viscid humours
in the body, or by contraction, that is to say, spasm of the cutaneous pores.
It is generally brought on, he says, by exposure to cold, or going into an
astringent bath. He gives very minute directions about the treatment, re*
commending hot baths, and friction with oils of a calefacient and attenuant
nature. — See also Aetius,Iib. iv.46. and Actuarius, Meth. Med. iii. 16.
Avicenna treats of it in the same terms as Galen. Lib. i. fen. 3. doct.
3. c. 15.
XXII. — ON SPONTANBOUS LASSITUDE.
These judicious observations are taken from Oribasius, Sj/nops. v. 21 . —
See alsoGalenus, de sanitate tuenda, lib. iv. — Aetius, lib. iv. 41. — Avicenna,
lib. i. fen. S. doct. 3. c. 16. — Alsaharavius, Prac^ lib. xxxi. §. 2. c. 11.
Rhases, Contin. lib. xxxi. — ^Averrhoes, Colliget. vi. 14.
All the authorities recommend nearly the same methods of treatment. Ga-
len's account of the subject. is full, complete, and satisfactory; but so lengthy,
that I cannot venture even upon an abstract of it. He gives proper directions
for the physician to endeavour to find out the cause of the lassitude, and to
remedy it accordingly. It is often connected, he says, with retention of the
menstrual or hemorrhoidal evacuation, or the stoppage of some customary dis-
charge. When attended with inflammatory symptoms, he is, properly, very
urgent in recommending immediate venesection, without which, as be re*
marks, the patient cannot escape with his life, unless he is saved by a critical
evacuation, such as bleeding from the nose, or profuse sweating.
When in the inflammative lassitude, the head is affected, Aetius directs
to open the cephalic vein; when the chest or back, the basilic; and when
the whole body equally, the median. He recommends also, cooling herbs,
nich as beet, mallows, lettuce, and the like, with ptisan and tepid water.
He forbids the use of cold water. After the third day, if the patient is con-
valescent, he allows a thin weak wine, much diluted.
Averrhoes approves very much of Galen's directions respecting the treat-
ment, except that the peppers recommended by him had not been found to
answer in nis climate (Corbuda). Instead of them, he directs to give cinna^
mon, amber, cassia lignea, and similar aromatics.
Avicenna joins Galen in cautioning the physician to be guarded in allow-
ing his patient to take much food, as the vems being emptied by the remedies
applied for removing the lassitude, greedily absorb the chyle before it is pro-
perly concocted.
70 COMMENTARY ON THE FIRST BOOK.
XXIII. ON THE REGIMEN OF OLD PERSONS.
This chapter is copied from Oribasius, Synops. v, 18. — See also Aetias,
lib. iv. c. 30. These directions are all borrowed from Galen, {Hyg. lib. v.)
-who has treated of the subject with his characteristic elegance and good sense.^
The following is a brief exposition of his views of practice in such cases : —
<' Old age is cold and dry, and is to be corrected by diluents and calefa-
cients, such as hot baths of sweet waters, drinking wine^ and taking such food
as is moistening and calefacient/' He strenuously defends the practice of al-
lowing old persons to take wine. He properly expresses his disapprobation
of giving them aloetic pills to remove constipation of the bowels, and advises
rather to keep them open with laxative herbs and oily clysters, in the manner
stated by our author. Aetius remarks, in like manner, that old men are much
hurt by strong purgatives, which only increase the disposition lo costiveness.
All that is required m such cases, he remarks, i^ to lubricate the rectum with
an injection of oil. The Arabians follow closely in the same strain. Alsa-
haravius recommends old persons to drink strong diuretic wines. He also
approves of the tepid bath, and fiiction with emollient oils. He disapproves
of much exercise and of taking aloetic pills, instead of which, he directs to
give oily clysters and laxative herbs. — Pract. xxvii. 10. — See more particu-
larly Averrhoes's Commentary on the Cantka oi Avicenna, tr. i. They
agree^ that if an old man had been accustomed to be frequently bled, the
practice is not to be wholly laid aside. Avicenna particularly approves of a
milk diet. He recommends to drink old red wines, but to avoid such as are
new and sweet. Lib. I. fen. 3. doct. 3.
XXIV. ON RU008ITT OF THE SKIN.
This chapter is taken from Oribasius, Synops. v. 20.
XXV. — TO MAKE THE PERSPIRATION FRAGRANT.
This is copied from Oribasius, Synops. v. 21 . — See alsoRhases, ad Mansor.
V. 53. — Rhases recommends to take the heads of cardui for food, and the
seed of juniper or cassia lignea in the drink. He also directs to rub the
body with pastils of roses, and to drink aromatic wine.
XXVI. TO WARM THE HABIT.
All this chapter is taken from Oribasius, excepting the part relating to
the draught or propoma. The nature of the Propomata will be explained in
the 7th Book.
XXVII. ON LIVIDITY,
This is taken from Oribasius. Synops, v. 24.
XXVIII. PRESERVATIVES OF THE TEETH*
This chapter is mostly taken from Oribasius. Synop. v. 25,
COMMSNTARY ON THE FIRST BOOK. 7 1
Rhases gives similar directioDS. He recommends to avoid emetics, and
to pay attention to keeping them clean. He recommends the following
dentifrice : — Of hartshorn, of the seeds of tamarisk, of cypenis, of spiken-
ard, of each 3)9 of the salt of gem 3ij, to be pulverised, and the teeth rubbed
with it. Ad Mansor, iv. 21.
XXIX. ON PRB8BRVATIVBS FROM DBAFNB88.
This is taken from Oribasius. Synops. v. 23.
Rhases particularly directs to avoid indigestion, which, without doubt, is
occasionally the cause of indistinct hearing. He recommends to introduce
some almond oil into the meatus, and to guard against cold wind. Ad
Mamor. iii. 23.
XXX.— ^ON DIMNB88 OF 8IGHT.
This is copied firom Oribasius. Synopt. v. 27.
Rhases gives very copious and sensible directions on this subject, but
many of them are the same as those given by our author. He directs to
avoid all gross and diffusible articles of food, and also thick wines. Al-
though he forbids to read books written in small characters, he recommends
to exercise the eyes, by looking at large letters or pictures. He also recom-
mends various coilyria, containing antimony, tutty, calamine, camphor, and
the like. Ad Mansor, iv. 22.
XXXI. ON REPLETION OR PLETHORA.
Our author, as usual, copies from Oribasius. Synops. v. 28.
Hippocrates describes accurately the bad effects of plethora, but at so
great length, that I cannot venture to give an outline of his practice. I may
mention, however, that purging with hellebore, emetics, the warm bath, ana
venesection, are his most powerful remedies. De Diata. iii. 16. et seq.
Galen also has a treatise of considerable length on the same subject.
Among the causes of plethora enumerated by him, I remark, that he men-
tions the use of the warm bath after meals, whereby he holds that the system
is overloaded with imperfectly concocted chyle. De Plenitudine, if Meth,
Med,\TL. 5. — See also Rhases, ad Mansor, ii. — Haly Abbas, Prac^ i. 12. —
Alsaharavius. Pract. v. 4. — Averrhoes, Comment, in Cantic. Avicenna, —
Avicenna, lib. i. fen. 2. doct. 3.
Alsaharavius says, that plethora is marked by ruddiness of the body,
heaviness, torpor, large veins, somnolency, a large face, and brawny limbs.
U is usually accompanied, he adds, by impairment of the understanding,
forgetfiilness, heaviness of the head, weakness of sight, great pulsation
of the arteries, and a disposition to epistaxis. He directs to use a restricted
diet, consisting of articles not very nutritious, to take exercise, the bath, along
with friction, and medicines calculated to evacuate the prevailing humour,
whether blood, phlegm, or bile.
Haly's account is very like our author's.
Rhases gives a good description of repletion, which, he says, is ge-
nerally brought on by excess in eating and drinking, along with too much in-
dulgence in sleep. Avicenna's description is similar.
72 COMMENTARr ON THE FIRST BOOK.
XXXII. — ON INTOXICATION.
Th£S£ simple directions are extracted from Oribasius. Sj^nopsUf v. 33,
Hippocrates recommends an emetic after intoxication, de DicstUy iii. 4.
For the cure of intoxication, Haly Abbas recommends the tepid bath,
aflfusion of tepid water, and friction with oil. If headach prevails, he directs
to pour cold rose oil on the head ; or, if it is summer, cold water. After
ill is, the person is to be rubbed, and to take things of a cooling nature, such
as prunes, tamarinds, and the like. PracL i. 8.
Khases recommends vinegar and water, or the like, for drink ; to apply
vinegar and oil of roses to the head, and camphor and water to the nose.
He also approves of emetics, and of putting the person's hands and feet into
cold water. Ad Mansor. v. 72.
The practice of taking an emetic after a debauch, is often alluded to in the
works of the classical authors. Thus, it is mentioned by Aristophanes in bis
Acharnenses. Suetonius, in the lives of Vitellius and Claudius, states, that
these Emperors were in the practice of procuring vomiting, in order to re-
lieve themselves from the effects of excessive eating and drinking. — See also
Plin. H. A', xiv. §. 28.
XXXIII.— ON WRONG DIGESTION OF THE FOOD.
See Oribasius' Euporiitj i. 3, and Sj/nops. v 30. This subject will be
more fully treated of in the 3d Book.
XXXIV. — ON VENERYr
The contents of this chapter are mostly taken fvom a fuller account of
(his delicate subject, given in an extract from the works of Ruffus, preserved
by Oribasius. Med. Coil. vi. 38.— See also Aetius, iii. 18. and Galenus^
Ars. Medica. — Avicenna, Cantica. — Averrhoes, Comment, in Cantica, and
Colliget vi. 7. — Rhases, ad Mansor. iv. 17. — Haly Abbas, Prac^ i. 10. 13.
— Alsaharavius, Thcor. tr. x.
Averrhoes says, venery, in a word, induces the following evils : dryness of
the body, effeminacy, imbecility, exhaustion, and at the same time, prostra-
tion ; wherefore the friction which is had recourse to, after it, ought to remove
the inconveniences occasioned by it. This should be much and rough fric-
tion, and be performed with oil.
According to Avicenna, excessive indulgence breaks down the powers of
the constitution, and superinduces either a cold intemperament or hectic
fever. Abstinence, on the other hand, by those who had been in the habit
of indulgence, is said to bring on heaviness of the head, and diseases of the
joints and testicles. In this case, he recommends rue, and various other
articles, which were supposed by the ancients to be possessed of anti-aphro-
disiacal properties. Cicuta, according to Pliny, produces this eiect.
Alsaharavius forbids coition when the body is either reduced by absti-
nence, or overloaded with too much food and drink. The proper season for
it, he says, is after sleep, when digestion is accomplished, and towards morn-
ing. It is prejudicial, he says, in very hot seasons, and to persons of a
dry intemperament. Rhases, like our author, says, that moderate indulgence
removes plethora, lightens the mind, and cures sorrow.
According to Haly Abbas, the most proper time for enjoymenl is after
digestion, and when the food has descended from the stomach. If performed
COMMXNTART ON THX FIRST BOOK. 73
before sleep, he says, there is most chance of impregnation. Abstinence,
when one bad become habituated to the act, he says, weakens the natnral
heat, hurts the breast, stomach, and liyer, induces coldness of the body, and
renders it dry, sluggish, and enervated. Excess, on the other hand, brings on
premature old age, and consumption.
It will be remarked, that our author and Alsaharavius, differ in opinion as
to the best season for partaking of the dwp iparh xpv^f A<l>podtTrj£, Sanc-
torius, the great moaem anthority on this subject, agrees with the latter.
One of his aphorisms, is as follows : — '* Coition is injurious after exercise,
after meat not so much; but after sleep it is the most wholesome of all." —
Non nostrum inter eos tantas componere lites 1
See a learned disquisition on this and other similar matters in the Sj/wpo-
siacon of Plutarch.
As an apology for having ventured upon the discussion of this subject at
all, I beg leave to quote the following epigram, wherein, as will be re-
marked, ** Venus*' is mentioned as one of tne three grand causes which pro-
duce health and disease : —
** Balnea, Vina, Venus corrumpunt corpora Sana,
Corpora sana dabnnt Balnea, Vina, Venus.'*
XXXV. ON IMPOTSNCB.
AxHENiEUS mentions that it was a practice with some to put sponges into
beds, as incentives to venery. He states upon the authority of Theophrastus,
that certain medicines are possessed of aphrodisiacal properties, to an almost
incredible degree. Deipnos i. 15.
The ancients held, that most of the testacea are aphrodisiacal — See Plau-
tus, Casinoy Ac. ii. sc. 8. 1. 59. and the note of Lambinius. — Ed. Grononii,
also Petronius Arbiter, Satyricon.
The rocket (eruca) was particularly celebrated as an aphrodisiacal herb. —
See Pliny, Ji. N, xix. 8. and Juvenal, Sat, ix. 134. Columella, in Hori.
Galenus, defac. alim. lib. ii.
On this subject, see Rhases, ad Mansor. v. 62, Continens, lib. xxiv.
Avicenna, lib. iii. fen. 20. tr. 1. — Alsaharavius, Pract. xxii. 11. Rhases
gives a long list of articles which were supposed to be possessed of aphrodi-
siacal properties, such as nettle-seed, elecampane, rape-seed, mint, rocket,
cresses, &c. Avicenna's account, however, is the ftiUest. He directs to rub
into the parts liniments, containing stavesacre, pellitory, squills, myrrh, assa-
foetida, and the like.
XXXVI. ON INORDINATE YENSRT.
This chapter is partly taken from Oribasius, Synops, v. 35. A similar
account is given by Rhases, ad Mansor. v. 67. Inordinate venery, he says,
occasions premature old age, dries the body, and brings on frigidity. Conn
iinens, c. xxiv. — See in like manner, Avicenna, lib. iii. fen. 20. tr. 1 . c. 36.
To restore the body when debilitated by excessive enjoyment, he recom-
mends a cale£stcient and diluent regimen, nutritious food, baths, aromatics,
and everyt hing that can exhilarate.
Sanctorius on this subject holds, that '^ coition to excess does great harm,
by heating and drying the body." Medicina Statica, sect. vi. ap. 38.
74 COMMBNTART ON THE FIRST BOOK.
XXXVII. ON REDUNDANCE OF SEMEN.
This chapter is taken with a very few slight alterations, from Galen, de
sanitate tuend&y yi. 14. The same treatment is recommended by Avicenna,
lib. iii. fen. 20. tr. 1. c. 35. and by Rhases, ad Mantorem, v. 67. Alsaha-
ravius recommends bleeding, and various cooling and astringent remedies,
both internally and externally. Pract, xxii. 9.
Hippocrates says, that the strychnos cuies impure dreams. De Diaia,
lib. ii. Serapion states, that the lettuce possesses '< virtus contraria sper-
mati.'' De simpL ex plantU,
We may remark here, once for all, that by the juice (xvXog) of herbs, the
Greek medical authors generally mean the decoction. Thus, according to
Dr. Coray, by ^vXor tS>v €p€piv6&v, Hippocrates undei'stood d(f)€yln]fia r. c.
Xenocrat, etjGalen ex aquat. p. 219 ; and, in like manner, as Le Clerc re-
marks, by x^\os TrTKTajnjs, was meant strained ptisan. Hist, de la Med,
XXXVIII. ON PERSONS WHO Hi^YB SUFFERED FROM COLD.
This chapter is taken from Oribasius, Sj/nops. v. 36.
Rhases directs to lay a person congealed with cold in a warm apartment,
and to rub with hot hands the whole of his body, with the exception of the
bead, which is to be warmed with hot cloths. Persons having warm bodies
are then to lie down in bed beside him ; and he is to take a draught con-
taining assafcetida, myrrh, pepper, and strong wine. When the respiration
is fairly restored, he is to take some nourishing food and wine ; and is then
to be covered up with many blankets and left to sleep. When he awakes,
he is to be put into a hot bath, and after remaining for a long time in it, he is
to be strongly rubbed when he leaves it with cale^ient oil, such as the oil of
lilies or narcissus, to which costus, castor, musk, and spurge have beeil ad-
ded. Ad Mansor. vi. 5.
Let the reader remark the similarity of the ancient practice in the cases of
persons who have been exposed to great cold, and of those who have been
poisoned with opium. — See Book v. c. 43. Galen remarks, that the effects
of opium and of the exposure of the body to extreme cold are very like
Comment, in Epidem.
In the 4th book of Xenophon's Anabasis, there is an interesting description
of the effects resulting from the exposure of the Grecian army to extreme
cold, and the means which they took to preserve themselves from being in-
jured by it. The historian relates, that they rubbed themselves before the
fire with an ointment composed of swines' seam, and oils of sesame, of bit-
ter almonds, and of turpentine. The Carthaginian soldiers of Hannibal, in
like manner, when exposed to great cold among the mountains of Italy, rub-
bed their bodies with oil as a protection from its effects, and with great suc-
cess, if we may believe Florus the historian- He says, *^ tunc callidissimi
hostes frigid um et nivalem nacti diem, quum se ignibus prius, oleoque fo vis-
sent (horribile dicta!) homines a meridie, et sole venientes, nostra nos hieme
vicerunt.^' Hist. Rom. ii. 6. — It is worthy of remark by the way, that Baron
Larrey, in his account of the retreat of the French army from Moscow, states,
that the inhabitants of southern climates endured the cold better than those
of the north. The fact, that the Carthaginian soldiers rubbed their bodies
with oil on the occasion we have mentioned, is stated also by Polybius, Hist.
iii. 72. and by Livy, Hist. Roman, xxi. 55.
Quintus Curtius relates, that the soldiers of Alexander the Great, rubbed
COMMJBNTMIT ON THX FIRST BOOK. 75
their bodies with the juice of sesame, instead of oil, when eiposed to intense
cold while crossing the Bactrian mountains. Lib. vii. c. 15.
Pliny, with his usual terseness, thus states the powers of oil in protecting
the body both from cold and heat : <* Oleo natura tepefacere corpus, et
contra algores munire : eidemque fervores capitis refrigerare.'' U, N, xv. 6.
XXXIX. — FOR FBR80N8 WHO HAVB 8UFFBRXD BT BXFOSURB TO
BXCBSSIYB HBAT.
This chapter is taken from Oribasius, Synopx. v. 37.
When a person has suffered from exposure to great heat, Rhases recom-
mends rest, the tepid bath, and fruits and food of a cooling and moistening
nature. When there is headach, he directs to anoint the head with oil of
roses and vinegar. Ad Maruor. vi. i.
Averrhoes recommends when a person has suffered from exposure to the
sun, to put him into a tepid bath, and rub him afterwards with refrigerant
oils. Collect. § iii. c. 9.
XL. ON COLLBCTIONS OF PHLBOK IN THB STOMACH.
This chapter is taken from Oribasius, who, in his turn, is indebted to
Galen.
A similar account of the matter is given by Rhases, Contineru, xi. tr. 1. —
He recommends emetics, Ad Maruor, iv. 16.
XLI. HOW TO PRODUCB BAST VOMITING.
This ehapt^ is abridged from Oribasius, Med. Collect, viii. 21. — ^The
opinions of Gralen, Diocles, and Archigenes, on this subject, may likewise
be learned from Oribasius. Galen recommends vomiting for collections of
yellow bile, and when the stomach is loaded with viscid matters, but forbids
it when the stomach is weak. The opinions of Celsus are very similar :
** Vomitus ut in secunda quoque valetudine ssepe necessarius biliosis est, sic
etiam in iis morbis qnos bilis concitavit. — ^Vomitus utilior est hieme quam
aestate ; nam tum est pituits plus, et capitis gravitas major subest. Inutilis
est gracilibus et imbecillum stomachum habentibus: utilis est plenis et
biliosis omnibus si vel nimium se replerunt, vel parum concoxerunt.'' These
rules of Celsus are approved of by Dr. Pemberton, on Abdominal Diseases.
—The directions given by Celsus for producing vomiting are very simple ;
^ Qui vomere post cibum volet, si ex facili facit, aquam tantum tepidam
ant^ debet assnmere : si difficiliils, aquae, vel salis, vel mellis paulum adjicere.
At qui mane vomiturus est, ant^ bibere mulsum, vel hyssopum, aut esse 1^-
diculam debet, deinde aquam tepidam (ut supra scriptum est) bibere.'' —
Galen commends the bulb pf the narcissus as an emetic. He forbids those
who have contracted chests to take emetics frequently. De Furgantibus
Medkinis.
Aetius gives an interesting account of this subject in an extract from the
works of Rufius. He forbids to excite vomiting when the eyes are affected,
or when haemoptysis is apprehended. He commends it for the cure of arth-
ritic diseases, dropsy, and jaundice. One of his simplest emetics consists of
the decoction of radishes, with the strained infusion of dried figs. He men-
tions the oil of Privet as a most effectual emetic. Lib. iii. c. 19.
Avicenha*s information on this subject is very ample ; but, upon the whole.
76 COMMBNTART ON THB PIRST BOOK.
his directions are mostly the same as our author's. He properly states, that
the too frec|uent repetition of emetics hurts the stomach, is prejudicial to the
chest, the sight, the teeth, in chronic pains of the head, unless arising from
sympathy with the stomach ; and in epilepsy, when the cause of it is seated
in tne head. Lib. i. fen. 4. — According to Avicenna and Averrhoes, the
proper season for emetics is the summer. Cant, p. i. tr. 1 .
llhases says, that much vomiting hurts the liver, breast, eyes, and lungs,
occasioning haemoptysis. He directs to bind a compress on the forehead
before taking an emetic ; and to wash the mouth and face with hydromel
after its operation. He adds, that persons who have long necks, prominent
chests, and who are lean, ought to abstain altogether from emetics. Ad
Mansor. iv. 16.
Haly Abbas forbids emetics in chronic complaints of the head and chest,
especially if the person be threatened with Phthisis. He says, that the repe-
tition of them weakens the stomach, and may induce haemoptysis. Pract. i.
12, 13. Alsaharavius delivers exactly the same detail of the cases in which
emetics prove hurtful or beneficial. Theor. x. 2.
Serapion gives a full account of these gentle emetics, De Antidotis, c. 36.
On the simpler methods which the ancients had recourse to in order to
produce vomiting ; see Prosper Alpinus, Med. Meth. iii. 1 0.
Dr. Paris says, '* The predilection of the ancients for emetics is the more
extraordinary, as they were acquainted with those only which were of the
most violent and unmanageable description ; the veratrum or white helle-
bore, was sometimes fatal.'' Pharmacologiay vol. i. It is certain, however,
that the ancients did not use the more violent emetics on ordinary occasions,
nor unless when it was found very difficult to produce vomiting. The learn-
ed Andreas Laurentius, physician to Henry the IV. of France, gives the fol-
lowing account of the ancient method of vomiting, which, it would appear,
was still practised in his time : '' Grsecis vomitus ante pastum matutini et
jejuui (Tvpfuutrfioi dicti, commendabantur. Quibus igitur hoc pacto vomere
pfacuerit, radiculas tenues, nasturtium, erucam, portulacam devorent, deinde
aqua tepida affatim hausta vomant. Veteres utebantur aqua mulsa mera-
ciore, succo ptisans ex aqua per se, vel cum melle decocto, et iis efficaciori-
bus surculis veratri albi in rafanum defixis, vel rafiwis solis postero die ex
aceto mulso comestis.*' De Strum. Nat. p. 274. I have been informed,
that several of the bulbous roots were formerly used in Scotland as domestic
remedies for producing vomiting.
XLII.-— ON LAXATIYBS AND DIURBTICS TO PBRSONS IN HBALTH.
ORiDAsr US treats fully of purgatives towards the end of the 8th Book of
Med, Collect. He gives a list of gentle laxatives. Euporist, i. 45.
Hippocrates frequently recommends gentle purgatives for the preservation
of the health. Of this class, the herb mercury appears to have been his fa-
vourite.
Galen has given two distinct treatises on purgatives, and the cases in whidi
tliey are applicable. He dissuades those who are in perfect good health
from taking them, but says that they may often be used so as to prevent the
recurrence of diseases. Hence, he says, that he had of^en prevented gout
and rheumatism from relapsing, by the seasonable administration of purga-
tives. He forbids purgatives when the hypochondria are distended with fla-
tulence.
Aetius gives a veiy lengthy account of the preparation of purgative me-
dicines, which, however, will be noticed more properly in the Seventh Book.
— He states, that all medicines of a cutting or penetrative nature are diuretic.
COMMSNTART ON THE FIRST BOOK. 77
He mentions plantain, fennel, parsley, beseli, anise, valerian, bitter al-
monds, &c. Lib. iii.
Celsus gives the following list of gentle diuretics : ** Urinam movent, quae-
cunque in horto uascentia boni odoris sunt, ut apiuro, ruta, anethum, ocimum,
mentha, hyssopum, anisum, coriandruro, nasturtium, eruca, feniculum:
prster h«c, asparagus, capparis, nepeta, thymum,satureia,lapsana, pastinaca,
magisque agrestis, radicula,siser, cepa; ex venatione, maxim^ lepus ; vinum
tenue, piper et rotundum et longum, sinapi, absinthium, nuclei pinei.'' — He
also gives a long list of laxative articles, such as cabbage, mallows, sorrel,
gourds, cherries, all ripe apples, green 6g8, cockles, oysters, muscles, milk,
crude honey, and all tatty and saltish substances. Lib. ii. 29. Horace
makes mention of the laxative properties of muscles, shell-Bsh, dock, and
white wine :
Si dura morabitur alvns,
Mitolus et viles peUent obstantia conchse,
Et lapaihi brevis herba ; sed albo non sine Coo.^ — Sat, ii. 4.
Avicenna gives very minute directions respecting the use of purgatives.
He very properly recommends when a purgative medicine has been taken,
and instead of operating, has occasioned heat, vertigo, and headach, to admi-
nister an injection. Lib. i. f. 4.
Haly Abbas treats of these medicines in pretty much the same terms as
our author. He remarks, that obstruction of the bowels leads to colic, flatu-
lence, difficult respiration, and vertigo. Retention of urine, he says, leads to
ulcers in the bladder. He states, that diuretics are useful in diseases of the
joints and spine, dropsy, and various complaints, but are apt to render the
body dry. Tract, Lib. i. 12. Diuretic medicines, he remarks in another
place, are of a hot and sharp nature, so that they heat the kidneys, and there-
by increase their attractive power. Lib. ii. c. 27.
Alsaharavius cautions against the indiscriminate use of purgatives, which,
he says, in a dry temperament disposes to phthisis, and to dropsy when the
stomach is weak. When a purgative medicine has induced hypercatharsis,
he directs to take astringent powders, containing sumach, pomegranate, and
the like. Theor.n.l,
Rhases gives some very sensible observations on the use and abuse of pur-
gatives. He says, that persons who lead an indolent life, are of a gross
habit, and live freely, are most benefited by them. To those of a dry tem-
perament, on the other hand, they prove prejudicial, by pre-disposing to hectic
fever. He recommends to eat fat food, and to go into the warm bath before
taking a purgative. — Ad, Mansor, Lib. iv. c. 15.
See a full account of these laxative medicines in Serapion de Antidotis,
XLIIL ON CLYSTERS.
Hippocrates frequently recommends the administration of clysters. He-
rodotus mentions, that the ancient Egyptians had recourse to clysters at
stated periods every month. Lib. ii. c. 77.
Oribasius has treated of the composition of clysters, and the cases in which
they are to be applied so fully in the Eighth Book of his Medica Collectanea,
that he may be said to have exhausted the subject. It appears from his ac-
count, that the ancients used a syringe for throwing up injections. A large
clyster, he says, amounts to three heminse, a small one to one hemina, and a
moderate one to two hemins. Si/nop, i. 19.
Celsus, after some very appropriate observations on the cases which are
benefited by clysters, concludes with the following directions for the compo-
Jition of them: — plain water may be injected, if the case be slight; or honied
78 COMMENTARY ON THE FIRST BOOK.
water, if stronger means be required ; if emollients be indicated; the decoc-
tion of mallows, of fenugreek, or ptisan may be used ; or if astringents be pro-
per, vervain. Acrid clysters may be formed of sea-water, or with the
addition of some salt, and their strength may be increased by boiling. Such
a clyster may be rendered still more acrid by the addition of oil, nitre, or
honey. He remarks, that the more acrid a clyster is, the greater will be its
purgative effect, but the more difficult will it be to bear. He says it ought
to be neither hot nor cold. After the injection has been thrown up, he re-
commends the person to remain quiet, and to resist the first desire to go to
stool. Lib. ii. c. 12.
Aetius treats of clysters very fully. He prefaces his account of the mode
of administering them, with a correct detail of the evils arising from consti-
pation, which, he justly remarks, is the precursor of most of the ills which
break out in the human frame. Lib. iii. 159.
See a long list of prescriptions for Clysters in Serapion, de AntidotiSy tr.
vii. 26. Rhases and Avicenna give a full account of the nature of clysters,
but supply no additional information on the subject.
XLIV. ON SUPPOSITORIES.
This chapter is entirely taken from Oribasius, Si/nop. i. 20. See a fuller
account in his Med, Collect, viii. 39. and Aetius iii. t60. Aetius, after
mentioning the composition of certain suppositories similar to those of our
author, speaks also of using for this purpose, figs mixed with nitre (soda ?)
and grapes deprived of their stones, with the addition of nitre and cumin.
Actuarius states, that it is when the obstruction is seated in the rectum
that suppositories are particularly applicable. Meth. Med, iii. 5.
See also Avicenna. Lib. iii. Fen. 20. tr. 1. and Rhases, Continens,
Lib. xxiv.
XLV. ON MEDICINES WHICH EVACUATE THE HEAD ON MASTICA-
TORIES, SRRHINES, AND LINIMENTS TO THE NOSE.
This chapter is taken from Oribasius, Si/ nop, i. 21.
Hippocrates makes frequent mention of the caput-purgiOf or medicines
which purge the head. On the composition of thes^ medicines, see in par-
ticular Aetius iii. 140, 141. — Nonnus, Epitome c. 17. and Serapion, de
Antidotis, Lib. vii. c. 31. They contain such articles as these: pepper,
nitre, white hellebore, spurge, gith, pellitory, mastich, turpentine, mustard,
chalcitis, alum, and the like. The errhines were used principally in obstruc-
tions of the nose, and when the sense of smell was impaired. The opo-
phlegmatismi were supposed to prove useful in chronic affections of the head,
impairment of the senses of smell and sight, and also when the tongue and
throat were affected.
Prosper Alpinus gives a full account of the errhines, masticatories, and
cough medicines of the ancients. Med. Meth, iii. 11. He makes the caput-
purgia to be the same as the errhines, and the apophlegmatismi the same
as the masticatories of the moderns.
XLVL — ON BMMBNAGOGUBS.
This chapter is taken from Oribasius, Synopi, i. 22. A fuller list of the
medicinal articles which were supposed by the ancients to promote the men-
COMMBNTART ON THE FIRST BOOK. 79
struS discharge, is given by Aetius. Lib. iii. 153, 154. It contains cassia,
myrrh, thyme, centaury, wormf^ood, nettle, elaterium, black hellebore, tur-
pentine-rosin, cumin, sage, and the like. All these were used in injections
and suppositories. The following were given by the mouth, and were held
to be likewise diuretic : hedge-mustard, rue, marjoram, southernwood, saga-
pene, galbanum, spikenard, the herb mercury, savin, iris, birthwort, &c. See
Albengnefit, LibcUus,
Dioscorides is censured by Dr. Cullen as being too credulous in assign-
iag fmmenagogue properties to a variety of articles in the Materia Medica.
Perhaps, however, there is some foundation for the doctrine of the ancients,
that all hot diuretic medicines are in so far emmenagogue. Prosper Al-
pinus maintains this opinion, but remarks, that the action of the emmena-
gogues is more uncertain than that of the diuretics, and must be assisted by
warm baths, pessaries, and fomentations. We will have occasion to treat
more fully of these medicines in the Third Book.
XLVIL— ON suDORirics.
This chapter is mostly copied from Oribasius, Synops. i. 23. Aetius enu-
merates a good many more medicines of this class. Of these some are to be
taken by the mouth, as cumin, bay berries, cyrenaic juice, castor, and lovage ;
some are to be rubbed into the skin, as nitre with oil, the oil of dill, of cha-
momile, of bays, and of radishes ; and some are to be used in fumigations,
as pennyroyal, the seed of balsam, and so forth. He recommends these
medicines in jaundice, and for coldness and constriction of the skin. Aetius,
Lib. iii. c. 157.
Celsus treats of the methods for producing free perspiration with more than
his usual minuteness. Sweating, ne says, may be produced either by dry
heat, or by baths. The modes of applying dry heat, which he mentions, are
by heated sand, the Laconicum or Sweating apartment of the ancient bath,
^e chap. 51 .) the Clibanus or moveable furnace, and the vapour baths of
Bais. To these he adds strong exercise. He also treats minutely of the ap-
plication of baths and fomentations for the cure of diseases. Lib. ii. c. 17.
Consult Stobeeus, c. 100.
Haly Abbas directs to restore the perspiration, when stopt, by exercise,
friction, baths, and the affusion of hot water over the body. He recommends
to perform friction with the oil of violets, and such things as are mentioned
by our author. Tract, i. 12.
Khases recommends internally, castor, opoponax, or opium mixed with
honey, and given in tepid water. Externally, he recommends friction, with
the oil of chamomile, of pelUtory, or the like. Continens, lib. xxxi. Mesne
mentions fumigations with calamint, cinquefoil, carpobalsam, and bdellium.
Albengnefit 'recommends the same, and also friction with calefacient oils,
and the internal administration of cumin, calamint, and the like.
The ancients, as Prosper Alpinus remarks, seem to have trusted more in
external than in internal means for producing free perspiration. They were
aware, that when the system is greatly over-heated, a draught of cold water
by reducing the temperature of the body may prove sudorific. This fact is
distinctly stated ' by Galen ; and in accordance with this principle, Rhases
directs to give cold water in the hot stage of the small-pox, to facilitate the
eniption of the pustules. The reader will find a similar view of the matter
stated in Dr. Currie's Medical Reports.
On the sudatoria or vapour baths of the ancients, see Baccius, dc Thermis,
lib. iv. Horace thus alludes to the vapour baths at Baise :
'^ Sane myrteta relinqui,
Dictaqne cessantem nerris eudere morbum
Sulphura contemni viciis gemit.'' — Epist, i. 15.
80 COMMBNTART ON THE FIRST BOOK.
Upon which SanadoD remarks : " By sulphur a, the poet means tlie Aves,
where sulphureous vapours exhaling from the earth cause a dry beat, which
provokes sweat."
XLVIII. ON AIRS.
The first part of this chapter is taken from Oribasius, Synopi, i. 24. The
remaining part will be found in the Med, Collect, ix. 1. — where the subject
is treated of at great length. — See in like manner, Aetius, iii. 162. All
these authors, however, are much indebted to Galen, de sanitate tuenda, lib.i.
According to Galen, the moon produces changes in the atmosphere, whereby
she occasions putrefaction of dead bodies, impairs the colour, and hurts the
head of living persons. De Diebus Criticts, lib. iii. On the supposed
causes why the moon occasions putrefaction, see Plutarch, Sympos, lib. iii.
Antyllus says, that there are many differences of airs; some arising from
the season of the year ; some from the changes of the moon ; . and some from
the hour of the day or night; some from thickness or tenuity, motion or rest,
or from the admixture of terrene exhalations. The sun, he adds, warms the
body ; but the moon rather humectates, and, therefore, she moistens the
brain, and occasions the putrefaction of the flesh; renders the bodies of those
who sleep in the open air more humid and obtuse; and, for the same cause,
she induces epilepsy and heaviness of the head. Cold air, he says, produces
plumpness, good nutrition, and the formation of fat; it promotes the growth
of the body, and hence, the inhabitants of northern climates are remarked to
possess this character. It is unsuitable, however, to all acute disorders ; and
18 also improper for certain chronic diseases, such as consumption, cachexy,
paralysis, apoplexy, and rheumatism. But warm air consumes the body,
attenuating and wasting the system, but it is preferable to cold air for im-
parting vigour and agility; it tries the powers, and is useful in affections of
the nerves and chest, but not in those of^ other parts. Thick air has no other
good property, except that it prevents the powers from being dissipated.
Thin air is most conducive to health. The air of high situations, is said by
him, to be more salubrious to all except persons labouring under diaphoresis
or syncope, and the aged. The atmosphere of places near the sea, he re-
marks, is milder than that of inland parts. Places in the neighbourhood of
marshes are at all times unhealthy ; but, in summer, their atmosphere is pes-
tilent. Those by a river side are cold and changeable. — See more fully Sto-
baeus, Sermo, xcix.
Hippocrates gives many interesting observations on the effect of climate,
and the state of the atmosphere, in influencing the health, but they are de-
livered so much in detail, that my limits do not admit of my entering into an
exposition of them. De Aeribus, aquis, locis.
Haly Abbas gives a very elaborate disquisition on this subject. He de-
scribes minutely the characters of salubrious airs, and the changes produced
upon them by the seasons of the year, the state of the winds, the nature of
countries, and the stars, that is to say, the sun and dog-star. Theorictty lib.
V. — See also Rhases, Continens, lib. xxxiii. — Avicenna, lib. i. fen. 2. doct. 2.
XLIX. ON WATERS.
Our author has given an outline of Hippocrates' opinions on this subject,
and for fuller information, I must refer to the works quoted in the preceding
chapter.
The characters of the different kinds of water, are thus given by Celsus
COMMBNTART ON THB FIRST BOOK. 81
with his usual terseness: ''Aqua levissima pluvialis est: deinde fontana;
torn exflumine, turn ex puteo; post hsc ex uive, aut glacie; gravior his
exlacu; gravissima ex palude/' Lib. ii. 18. Their characters are some-
nvhat differently given by Athensus. Thus, he states, that water from snow
or ice is lighter and better than rain water; otherwise his remarks on the
qualities of waters are very interesting. He directs to take a moderate draught
of water at the commencement of a feast, in order that the veins, being in so
hr filled by it, may not greedily absorb the chyle before it is properly con-
cocted.— See DeipnosophUta, lib. ii.
Our author's account is abridged from Galen and Oribasius, Collect. Med,
lib. X. or rather is copied entire from Euporist. i. 14. Aetius gives a full
account extracted from Ruffus, lib. iii. 165.
Haly Abbas treats of this subject at great length. His characters of the
different kinds of water agree very well with those given by our author. He
states that rain water is the purest, and snow water the most impure. Haly
AbbaSy like our Mr. Abernethy, condemns the indulgence in a copious
draught after a meal. The reasons he assigns for its proving injurious are,
that it prevents the surface of the stomach from coming into proper contact
with the food, and also that it reduces the natural temperature of the stomach.
He recommends, if thirst be urgent, to allay it by drinking a small quantity
slowly. Theories, v. 29.
Alsaharavius advocates similar views. He also forbids to drink during
the night, as the sensation of thirst may be fallacious ; and at all events, he
says, it is only increased by indulgence. Theor, xiii. 1, and xii. 2.
Rhases^in like manner states, that a draught of water immediately after
eating impairs digestion, but is proper after digestion has taken place.
Continens^ lib. xxxiii. (Upon this principle we may see the propriety of
not taking tea until a few hours after dinner.) Rhases, in another place,
states that ice is prejudicial to the health, especially of old persons, by con-
gealing the stomach and hurting the nerves. He admits, however, of the
use of water cooled in snow, but recommends to counteract its effects by a
moderate allowance of wine. Water which has been drawn from a very
deep well he directs to boil before using it. Lib. xxxvii. tr. i. 70.
"nie following are the principal beverages of the Greeks and Romans :
Wine diluted with water; Mulsum, or a composition of honey and wine,
resembling the modem clary ; Hydromel, or honied water ; Zythi, or various
kinds of ales ; the Spathites, a wine prepared from palms, mentioned by our
author, lib. iii. c. 39 ; the Sicera, or cider prepared from apples; Perry, pre-
pared from pears ; Posca or oxycrate, a mixture of vinegar and water ; the
Cyceon, a mixture of wine, honey, flour, and water, according to Hesychius;
the Dodra of the Romans, very like the cyceon ; Ptisan, prepared from
polenta ; Barley water, mentioned by Hippocrates, de Morh. Acut. and well
described by the Arabians.
LI. — ON BATHS.
It is to be recollected that the baths of the ancients contained three dis>
tinct apartments. The construction of them is thus described by Wouwer in
anote on Plautus, Act i. sc. 2. 1. 1 : "Tres eedes seu cellae inbalneis. Prima
est CaldariCf ro Acuc&pueoPf Dioni nvpunmipiop, Senecse Sudatorium, nam
sicco calore sudorem in eo eliciebant. Secunda est media, quae et Tepidaria.
Tertia est Frigidaria.** Ed, Gronov,
Hippocrates thus explains his views of the effects produced by baths: The
hath or sweet water humectates and cools, for it imparts moisture to the
l»dy. The salt bath is calefocient and disiccative; for, being naturally hot, it
Q
82 COMMBNTART ON THE FIRST BOOK.
attracts moisture from the body. Wben the body is fasting the hot bath
is attenuant and refrigerant ; for by its heat it attracts the moisture from the
body, and when the flesh is deprived of moisture the body is cooled. But
after a meal it heats and humectates, by expanding to a greater bulk whaU
ever predominates in the body. The cold bafiis produce the contrary
effects ; for when the body is fasting they impart heat and moisture to it, and
after a meal they abstract moisture, and being cold they fill it with dryness.
Unction with oil is calefacient, moistening, and emollient. De Diata, ii. 36.
In another place, he states that the warm bath in moderation softens aqd
enlarges the body ; but when taken immoderately it humectates dry bodies,
and dries humid bodies. De AffectionibuSf c. 47.
Celsus gives some ingenious reflections on the effects of the bath^ espe-
cially in fever. He thus states the purposes for which it is applied : '' Fere
adhibetur, ubi summam cutem relaxari, evocarique corruptum humorem, et
habitum corporis mutari expedit.'' He recommends friction with oil before
going into the bath. Lib. ii. c. 17.
Psellus says that the warm bath relaxes, softens, and induces sleep, oc*
casioning plumpness of the body. Opus Medicum.
Our author copies from Oribasius, Euporist. i. 16. — See a fuller account
in Med, Collect, lib. x. Galenus, de Sanitate Tuerida, Aetius, iii. 169, and
Avicenna, lib. i. fen. 3. d. 2. Galen particularly recommends the cold bath
to persons in the prime of life, and during the summer season. Before
going into the bath he directs to get well rubbed first with rough towels and
then with oil. He recommends to plunge into the water at once and not
descend gradually. After coming out of the water he directs to get rubbed
with oil until the skin is warmed. Agathinus forbids to bathe in&nts in cold
water, but recommends the warm bath for them. Oribasius, ii. 7.
The ancients used baths medicated with mallows, linseed, or fenugreek,
when they wished to make tliem particularly emollient; and with roses,
pomegranate rind, or plantain, when they intended to render them astrin-
gent. Oribasius, u, «. They prepared hip baths also in this manner.—
Aetius, u, s,
Galen and Aetius direct to form the bath of oil by adding the fifth-part of
heated oil to a bath of water. They recommend it in protracted fevers at-
tended with chilis, convulsions, retention of urine, and to relieve lassitude
and nervous pains. The learned Bernard remarks, that it roust have been
the expense with which it is attended that has led to the disuse of the bath
of oil. Ap. Nonni Epitom. Avicenna and his expositor, Grentilis Fulginas,
particularly commend it for retention of urine. Mengus Faventinas pro-
nounces it to be highly anodyne.
Actuarius forbids the use of the bath to those whose systems are loaded
with superfluities and bad humours. De Diata, c. xi. Averrhoes lays down
the same prohibition. Collectan. ii. 4.
The proper time for the bath, according to Haly Abbas, is after exercise
and before eating. If used before exercise, it proves injurious, by occasion-
ing the distribution of any superfluities which may be remaining indigested
in the body, and determining them to improper parts. If used immediately
after a meal, he says, it proves hurtful, by promoting the absorption of un-
concocted chyle, and sending humours to the head. But, if used after exercise
and before a meal, it moistens the body, strengthens the vital heat, promotes
digestion, opens the pores, mitigates pain, and dispels flatulence. He adds,
a short continuance in the bath warms and moistens the body, but a long
warms and dries it. Theor, v. 13. In another place he says, that the proper
time for the bath is after exercise, vet not immediately, nor until the powers
of the system are in so far recruited ; but the body is to be first rubbed with
oil, and then the bath is to be taken, Pract, i. 5.
COMMBNTAKT ON THE VIRST BOOK. 83
The uses of the bath, according to Alsaharavius, are, to moisten the body,
open the pores^ dispel flatalence, remove repletion, procure sleep, relieve
pidnsy fluxes of the bowels, and lassitude, to restore lean bodies to plump-
ness and obesity if used after a full diet, to soften contracted limbs, moisten
dry bodies, and dry humid. The evil effects of it when misapplied are pros-
tiation of the vital powers, syncope, and determining the humours to weak
parts. TAeor. xi.l.
Aselepiades, a celebrated physician in the time of Pompey the Great, was
a distinguished advocate for the use of the bath. — See Plinius, H, N. xxxvi.
3. Celsas, ii. 6. Apnleius, Florid, c. 4.
Mercurialis gives an excellent account of the public baths of the Romans, de
Arte Oymnastka, i. 10*— On the construction of them, see Vitruvius, Arch.
V. 10. But for a full account of every thing relating to baths, see Auctores de
Balnets, Venet. 1553, and Baccins de ThermU^ Roma, 1 622. Baccius thus enu-
merates the general effects of the warm bath : ** Humectat in primis, et calefkcit
Uandissim^ : mox aperit, lenit, attenuat, digerit, revellit, maxim^ calidius.
Deinde urinas ac alvum ciet, sudores ac habitus insensibi les excitat. Dolores
mitigat, somnum conciliat, bonas concoctiones molitur, ac vires corroborat.*'
LIL— ON THB NATURAL BATHS.
This chapter is taken from Oribasius, Synops. i. 29. A fuller account is
given in ^ Medka CoUectaneOy x. 3. «^ uq. See further Aetius, iii. 167.
Haly Abbas, TAror. v. 13. Rhases, Conhneiif, lib. xxxvii. Avicenna, lib.
ii. tr. 2. c. 15.
Pliny enumerates ftilly the good effects of the natural baths at Baiae,
fl. N. xxxi. 2.
Aetius' account is borrowed from Archigenes, and is much the same as
our author's. He recommends the sulphureous bath for the cure of alphos
and nielas, leprosy, scabies, impetigo, old ulcers, scirrhus of the liver, spleen
and utems, paralysis, arthritic diseases, and prurigo. Rhases and Avicenna
also recommend it in these complaints.
The principal natural baths, as they are called, are those impregnated
with sulphur, alum, soda, saltpetre, iron, or copper. Baccius also makes
mention of water impregnated with lead, mercury, bitumen, antimony, and
arsenic. His directions for the use of them are most important, but unfor-
tanatriy tay limits will not permit me to do justice to them.
Georgios Agricola particularly commends the sulphureous bath for the
care of arthritic diseases.
LIII.— ^N T&K EBOIMBN BBFITTINO THB DIFFBRENT SBASONS.
Tsii ig copied from Oribasius, Euporist. i. 10.
It is one of the Aphorisms of Hippocrates, that those who require blood-let-
ting or medicine should be bled or take medicine in the spring. Aphor. sect,
vi. Galen, Rhases, Haly Abbas, and in short all the ancient authorities
agree with bim respecting this rule of practice, which is still frequently fol-
lowed by the common people in Scotland. According to Alsabaravius, the
palte is stronger and foller in spring than at any other season. Theor. vii. 2.
Hippocrates and Gralen linr it dovm as a general rule that the fullest diet
is most proper in vrinter, and the sparest in summer. Aphor, i. 18.
Rhaiei lays down very suitable directions for the regimen that is most
proper during every season of the year, but they are scarcely at all different
rat our authoi^s. As we have mentioned, he recommends depletion in
62
I
84 COMMENTA.RY ON TH£ FIRST BOOK.
•
spring before the heat set in. In sununer, he approves of cooling acid fruits
with cold water for drink. In autumn, he directs to abstain from cold baths
and to use a restricted regimen. In winter, he recommends a full propor-
tion of calefacients, such as pepper, cumin, mustard, and rocket. Ad, Man-
$or. iv. 26. Winter, he says in another work, favours the formation of flesh
and blood, braces the body, and strengthens the powers. Spring fills the
system with humours. Summer dissolves the humours, and weakens the
internal powers. Autumn engenders bad humours, bile, and blood. Contij
nensy lib. xxxiv.
Haly Abbas recommends purging or bleeding in spring, to evacuate the
superfluities formed and shut up in the system during winter. In summer,
the regimen is to be cooling and diluent, little exercise is to be taken, the
cold bath is to be used, swimming in cold water is to be practised ; for food,
chickens, flsh caught among rocks, grapes, apples, and the summer fruits,
will be proper; but wine is either not to be drunk at all, or much diluted
with water and cooled in snow ; and venery is to be avoided. In autumn,
the regimen is to be cooling and disiccative, the exercise moderate, the cold
bath is to be avoided but the tepid is to be taken, and much fruit is to be
avoided. In winter, the regimen is to be heating and disiccative, and wine
is to be taken moderately. The wine, he adds, ought to be strong and
heating, to counteract the cold of winter; but much must not be taken, be-
cause it will dilute and humectate the body which stands in need of disicca-
tion. Wine, too, he says, possesses little nourishment, whereas the system
requires much support in winter. He recommends the flesh of quadrupeds
and fowls for food. Fracticay lib. i. See, in like manners Avicenna, lib. i.
fen. 3. div. 5. Alsaliaravius, Theor. ix. 2.
The poet Ilesiod recommends a full diet in winter. Opera et Dies,
I. .558.
Maximus Planudes, in a declamation in praise of winter, aflirms that at
this season the heat, being confined within the body, operates more strongly
in performing the vital functions than at any other season. This season, he
says, is favourable to all classes of men except doctors ; but they are sick at
heart to see that no other persons are sick, and, bewailing their own misery,
undergo the thirst of Tantalus amidst the rains of winter ! V. Boissonade,
Anecdota Graca, vol. ii.
LIV. ON THB REGIMEN OF PERSONS EMPLOYED IN BUSINESS.
Thi3 is taken from Oribasius, Si/nops. v. 29. who extracts it from the Com?
mentaries of Galen. — See also Rhases, Cont. xxxiii. Galen and Rhases
remark that persons who lead an active life, such as ploughmen and la-
bourers, digest gross food more readily than any others ; but that, their bodies
being wasted by excessive fatigue, the vessels take up the chyle before it is
properly concocted and carry it over the system. Hence, such persons
bcldom attain to an old age, as their bodies get loaded with improper juices.
liV. ON THE REGIMEN FITTING FOR TRAVELLERS,
uis chapter is taken from Oribasius, (^Synopt, v. 31.) who admits that he
borrows in his turn from Diodes. The directions are upon the whole very
judicious and proper.
Galen forbids travellers who have been exposed to great cold to take heat-
ing things immediately after a journey. Meth. Med,
Avicenna, Averrhoes, and Haly Abbas direct to get bled before entering
COMMBNTART ON THE VIBST BOOK. 85
upoD a journey ; and, in certain cases, this might be a very proper practice to
prevent the blood from being inflamed by violent exercise, but, on the other
band, unless judiciously applied, it might bring on such debility as would
render the traveller unable to undergo the nece:»sary fatigue. They recom-
mend to hold in the mouth a small ball of the trochisk of camphor. The
Arabians, it is to be recollected, maintained that the action of camphor is
frigorific, and on this point Dr. CuUen agrees with them. Instead of the
draught mentioned by our author, Avicenna recommends vinegar and water.
He recommends to take little food, but of good nourishment ; and to avoid
pot-herbs and fruit. With regard to the treatment of the feet, he directs to
rub them until they become warm, and then anoint them with hot fragrant
oils. When the feet have suffered from cold, some, he says, put them into
cold water and are thereby relieved, in like manner as congealed fruits are
sometimes restored. When the water for drink is bad he advises to get it
distilled.
Haly Abbas gives very minute directions for the conduct of travellers.
Like our author, he advises to gird the body with a swath or band, and to
use a staff. He forbids to begin a journey either fasting, or in a state of
repletion with food. Exposure to the sun, he says, is apt to occasion hectic
fevers, headach, consumption, and dryness of the body. He directs to have
the head covered. When hurt by exposure to heat, he advises to pour cold
water, or any other thing of a cooling nature, over the head. After exposure
to cold, he recommends the hot bath. Pract. i. 31.
Rhases remarks, that he had known all persons who had been exposed to
great heat during a journey suffer from attacks of fever, except those of a
humid and phlegmatic temperament. He forbids to take much food before
setting out on a journey. He recommends, if convenient, to take a bath at
the close of the day, then to eat and go to sleep. He, and all the authorities
quoted by him, direct to rub the body with oil before and after a journey.
To preserve the eyes from the effects of snow and dust, he recommends to
expose them to the vapours produced by pouring wine on a heated stone,
or to those of camomile, dill, or marjoram. To protect the feet, he directs to
wrap them in cloths smeared with calefacient oils. When very hot, he
cautions against swallowing much cold water at once, but recommends to
hold some cool liquid in the mouth, and to pour cold water on the hands
and feet. He recommends travellers to chew pickled onions. It is well
known, by the way, that the Scotch Highlander can support a great degree of
fatigue by eating onions. During the prevalence of extreme cold, he ap-
proves of drinking some hot wine before setting out on a journey. When
the journey is over, he directs the traveller to go into a comfortable apart*
ment, but not to approach the fire, nor enter the bath, nor allow himself to
sleep during the space of an hour. After this, he may go into the bath and
undergo friction until his body become ruddy, and then he may go to sleep
on a soft bed ; by which regimen he may be preserved from fever, if such
be the will of God. Continens, xxxiv. Ad Mamor. vi. 3. and 4.
LVI.-— ON THB BBOIMBN OF PBRSON8 AT SEA.
This chapter likewise is taken from Oribasius, {Si/nop. v. 33.) who copies
^ Diocles. Similar directions are given by Rhases, Avicenna, and Haly
Abbas. Haly remarks that persons on board of a ship are often infested
with lice, which are engendered by want of cleanliness. For them, he re-
conmiends mercury killed, with oil, the long bithwort, &c. Pract, i. 31.
Avicenna says, that by wearing wool smeared with oil and mercury the
Hce will be killed. Can*, p. ii.
86 COMMKNTART ON THB FIRST BOOK.
When the vomiting is unusually severe and protracted, Ithases recom-
mends to treat it with anti-bilious remedies. Ad Mansor. vi. 14. Continenif
xxxiv.
LVII. — TO REDUCB OBESITY.
This is taken from Oribasius, St/nop. t. 40. Aetius uses nearly the same
words, lib. iv. 32. Celsus recommends the tepid salt-water bath, hard exer-
cise, food of an acid or austere kind, and restricted sleep, lib. i. 3.
Galen gives an interesting account of the manner in which he cured a per-
son of obesity in a very short space of time . He says : '* I first made him take
quick exercise, and aftervrards wiped off the sweat with a linen cloth. I then
rubbed his body with the volatile ointments called acopa, and after this fric-
tion I led him to the bath. I did not then give him food presently, but
directed him either to rest, or follow any occupation he was iocHned for, and
then repeated the bath ; after which, I gave him as much food, not of a very
nourishing description, as he was disposed to take." X)e Sanitate TuendOy
vi. 8.
Avicenna directs to use hard exercise and frequent baths, and to drink
vinegar, lib. i.fen. 3. d. 4. Rhases recommends to abstain from animal fbod^
wine, milk, and all sweet things; to live upon pot herbs, and siich things as
are saltish and sour ; to take purgatives and diuretics, to use much hard ex-
ercise, and to remain long in the bath. Ad Mansor. v. 61. In another work
he treats of this subject at great length. He recommends acids, and espe-
cially vinegar. In short, he agrees with Galen, that all things of a bitter,
sour, and attenuant nature, reduee obesity ; and also that saltish things which
have the property of opening the bowels do the same. Nothing, he says,
tends more to reduce corpulency than frequent baths and hard friction. Corh'
tmenSy lib. iv.
The directions given by Haly Abbas are to the same effect as those of
Rhases — that is to say, he recommends to take hard exercise, to remain long
in the bath, to use friction with oil of dill and the like, to live upon article»of
food not too nutritious, not to indulge in protracted sleep, and to have fre-
quent recourse to laxative and purgative medicines. Ptact, i. 16.
Some remarkable cases of obesity are related by Athenteus. Deipnoi. xii. 12.
The practice of the Methodists is described in a very circamstaQtial man-
ner by Ccelius Aurelianus, Tard. Past. lib. v. 9. They very properly con-
demned bleeding and purging, and depended principally upon strong exer*
cise, hard friction, and a restricted diet.
LYIII. HOW TO RECRUIT TH08B WHO ARE BMACIATBD.
Tnis is either copied from Oribasius, Sjfnop. y. 41. or from Aetiiis, till. iv.
58. The process of pitching the body is thus described by Aetius : — " Dried
pitch is melted in a moderate quantity of oil, and while still warm is to be
rubbed into the skin (the part having been previously shaved), and before it
cools completely it is to be torn away. The plaster is to be again heated at
the fire, and spread upon the skin ; and before it becomes cold, it is to be
torn away. This process is to be frequently repeated.'' Lib. iii. 180. See
Celsus, lib. i. 3.
Haly Abbas recommends moderate exercise, a short continuance in the
bath, friction with emollient oils, much sleep, two or three meals every day,
food consisting of fat meat, bread, almonds, &c. He also approves of pitch-
ing. Pract. i.l6.
COMMBNTAKT ON THE FIRST BOOK. 87
Avicenna recommends pitching, soft friction, and the rest of the treatment
recommended by Paulus, lib. i. fen. 3. Doct. 4.
Rhases treats of the same at great length. He approves of protracted sleep ;
of food consisting of fat meat, wheat, and pulse ; af\er food, of the bath, fric-
tion with oil, and the effusion of tepid water over the body ; and also of red,
thick, and sweet wines. Ad Mansor. v. 60. In another work he delivers the
opinions of preceding authorities, accompanied with his own remarks. He
agrees with Galen, that emaciation generally depends upon the state of
the liver. They recommend nutritive articles of food, such as boiled and
roasted flesh, and the bath without friction after a meal. Both speak fovour-
ably of pitching. They also approve particularly of sulphureous and bitumi-
noos baths. With regard to the bath, they explain, in another place, that it
is proper in these cases only afler the food is digested ; for, if taken too soon
after, it loads the body with unconcocted chyle ; and that, if had recourse to
at other times, it rather induces emaciation, lihases again repeats that many
of the legumina are very nutritive, which statement is con6rmed by Dr.
Colleo. He states that the vrine should be particularly thick. Continens, lib.
xiv. GaleOy in another place, says that emaciated persons are to be recruited
by thick wines, food consisting of thick juices, short exercises, and moderate
finction. Meth, Med, xiv. 16.
On the treatment of convalescents, consult Celsus, lib. iv. c. 25, Galenus,
V^g' and particularly Rhases, Continens, lib. xxxiv. We shall give Celsus'
directions in his own words :-^^ Ex quocunque autem roorbo quis convales-
dt, si tarde confirmatur, vigilare prim& luce debet; nihilominus in lectocon-
quieseere : circa tertiam boram leniter unctis manibus corpus permulcere :
deinde delectationis causa, quantum juvat, ambulare, circumcisa omni nego-
tiosa actione : tnm gestan diu : multa frictione uti : loca, caelum, cibos sspe
motare : ubi triduo quatriduove vinum bibit, uno aut etiam altero die inter-
ponere aquam. Per hxc enim fiet, ne in vitia tabem inferentia incidat, et
ttt mature vires suas recipiat. Cum vero ex toto convaluerit. periculos^ vits
genus subito mutabit, et inordinate aget. Paulatim ergo debebit, omissis his
iegibos, eo transire, ut arbitrio suo vivat." — Galen and Rhases particularly
lecommend to convalescents to drink white astringent wines diluted with
water. Both enjoin a restricted diet at first, gentle exercise, and the bath in
moderation. Haly Abbas cautions against premature friction and exercise,
bot recommends the tepid bath, and gentle unction with oils, Pract. i. 25.
Syiaat recommends the warm bath, moderate friction with rough towels, and
auction with a little oil. V. Auctores de Balneis, p. 334.
LIX. HOW TO RSMEDT EMACIATED PARTS OF THE BODY.
This is taken from Oribasius, Synops. v. 42, or Aetius, iv. 34. See also
GalenuSy de Sanitate Tuenda, lib. v. Rhases, Continens, lib. xiii. Haly
Abbas, Pract. i. 16. Avicenna, lib. i. f. 3. d. 4. All recommend to pour
water on the part, and then to rub it with towels and hot stimulant oils, so as
to produce a redness and glow in it. Most of them also approve of the pitch
plttter.
The earlier modem authors in like manner recommend fomentations, fric-
tioD, and the pitch plaster. See Lamfrancus, doc. i. tr. 3. and Theodoricus,
Kb. ii. c. 25.
LX. DESCRIPTION OF THE BEST TEMPERAMENT.
This chapter is copied from Oribasius, Synopi.v. 43. or Aetius, lib. iv. 53.
^ also Galenus, de Temperanientis, de Optima Corporis Comtitulione, de
88 COMMKNTARY ON THE FIRST BOOK.
Sanitate Tuenda, lib. v. and Ars Medka, In the last-mentioned, which was
long the most celebrated of all his admired works, he has treated of the tein*
peraments very systematically. Whatever Oribasius, Paulus, or any subse-
quent author, whether Greek or Arabian, have delivered on this subject, is al-
together derived from the works of Galen.
None of the Arabians has treated of the temperaments so learnedly as Haly
Abbas, Theories, lib. i. See also Averrhoes, CoUiget. lib. vi. Alsaharavius^
Theor, tr. vi. Avicenna, Cantica.
XLL ON THE CHARACTERS OF THE INTEMFERAMENTS.
This chapter is taken from Oribasius, St^ps. v. 44. who borrows from
Galen, Ars Med. c. 15. See also all the authorities referred to in the pre-
ceding chapter.
The ancients, it will be perceived, connected the passions and desires of
the mind with the temperaments ; and, to establish the alliance between them,
Galen wrote a treatise, wherein he has handled the subject very ingeniously,
and has delivered many profound views of the animal economy. I have often
wondered that his arguments have never been turned against the phrenologists
of the present day. The application of them I need scarcely point out, as it
mt>st be obvious that if tlie passions, affections, desires, and dispositions of the
mind, arise from the temperaments, the phrenologists have erred in referring
Ihem solely to the configuration of the skull. Galen*s work, to which I al-
lude, is entitled, QuodAnimi Mores Corporis Temperamenta sequuntur.
LXIL ON THE CONFIGURATION OF THE HEAD.
This chapter is taken from Oribasius, Synops. v. 45, Aetius, iv. 63, or di-
rect from Galen, Ars Medica, c. 6.
Psellus, like our author, remarks, that a small head, by contracting and
binding, as it were, the brain, is necessarily a bad formation ; whilst a large
head, if it arises from excess of the natural powers, is good ; but if it is occa-
sioned by a collection of superfluous matter, the contrary. Here again we
are furnished with another serious objection to the phrenological hypothesis.
For surely, granting that the passions and dispositions depend upon the con-
struction of the head, the quality as well as the quantity of its component parts
ought to be taken into account, as regulating its operations.
LXIII. — ON THE CHARACTERS OF THE TEMPERAMENTS OF THE BRAIN.
This is taken from Oribasius (Si/n. v. 46.^, who abridges Galen. Ars
Medica.
As our authoc's description of the temperaments is sufficiently intelligible,
and the others, whether Greeks or Arabians, deliver exactly the same views
of the subject, without any material improvement, I consider it unnecessary
to multiply references to, and extracts from them, on the present occasion ;
and, therefore, instead of crowding my pages with superfluous repetitions, I
shall give in this, and the five following chapters, a brief exposition of the
physiological doctrines of the ancients, with regard to the principal organs of
tlie human body : —
The ancients divided the powers or faculties of the human body into the
natural, the vital, and the animal. The brain they held to be the seat of the
animal powers — that is to say, they considered it to be the organ from which
COMMSNTAEJ ON THK FIRST BOOK. 89
sensatioD and motion are derived, and these, thev maintained, are the powers
l^ which animals are distinguished from vegetables. This doctrine is fully
explained by Galen, in his work, de FacuUatibm NaturalUnii, and by
several of the Arabian authors, among whom I will venture to mention Haly
Abbas, as being particularly worthy of being consulted on this subject. The
brain, then, was accounted the seat of the five external senses, and of muscu-
lar motion, which also was reckoned as one of the senses by Hippocrates, (De
Imomniisy c. 1 .) I may mention, by the way, that the late Dr. Brown, and
the present Dr. Abercrombie of Edinburffh, adopt the arrangement of Hip-
pocrates. Galen and his followers decidedly taught that the nerves of the
senses are distinct from those which impart the power of motion, that the
former derive their origin from the anterior part of the brain or cerebrum, and
the latter from the posterior, called by the Greeks encephalis (under this term
they comprehendea the cerebellum, tuber annulare, and medulla oblongata of
modern anatomists), or, from its process, the spinal cord. They maintained
that the nerves of the finer senses are formed of matter too soft to be the vehi-
cles of muscular motion ; whereas, on the other hand, the nerves of motion
ure too hard to be susceptible of fine sensibility. Willis, and lately Mr.
Charles Bell, in his reply to an article of mine in the Medical Gazette (May
2, 1829), on the opinions of the ancient physiologists with regard to the
nerves, deny that the nerves of sensation are softer than those of motion.
Ackerman and Malacarne, however, maintain that the opinion of Galen on
this point is perfectly correct, and with them I entirely agree. Let any per-
son attentively examine the gustatory and muscular nerves of the tongue, and
he will be sensible of the superior softness of the former. As my limits will
not admit of my giving a full explanation of this celebrated theory, which
was lately revived with great eclat, I must be content with referring to Galen,
de Usu Fartiuniy lib. ix. de AdmmUt. Anat. lib. vii. ; to Haly Abbas,
Thearica, lib. iv.; to Averrhoes, CoUiget, iii. 33.; to Avenzoar, ii. 7. ; and to
Rbases, Continens, lib. i.
The ancients were also of opinion, that the brain is the coldest viscus in the
animal frame, being in this respect the antagonist of the heart, the heat of
which they supposed that it counteracts. See Aristot De Part, Anim. ii. 7.
and Pliny, H. ^T. xi. 49. There appears to be some foundation for this opi-
nion, since, as is remarked by Haly Abbas, those parts of the body which
are vascular, and contain much blood, are naturally hot; whereas such as
contain little blood are comparatively cold. Of this latter class, are the brain,
nerves, and fat. Theor. lib. i. .
LXIV. ON THB CHARACTEE8 OF THE TEMFKEAMBNTS OF THE
STOMACH.
We shall now state briefly the opinions of the ancients with regard to the
functional office of the stomach.
Actuarius says, '' I am of opinion, that there are four species of concoction
which are performed in different parts of the body ; the nrst in the stomach ;
the second in the vena ramalis (vena portae ?), meseraic veins, and concave
part of the liver ; the third in the convex part of the liver and veins proceed-
mgfrom it; and the fourth, consisting of febrication or assimilation which
takes place in the extreme parts of the body.'' De UrinU. The various
modes of change or concoction which the food undergoes in the body, are
minutely described by Macrobius. Satumal, lib. vii. In another place,
Actuarius says, '* Digestion is performed by moderate heat and moisture.*'
De Spiritu Animali, p. ii. § 1. Alsaharavius in like manner states, that the
digestive faculty depends partly on the heat, and partly on the humidity of
90 COMUKNTART ON THB FIRST BOOK.
the stomach. Praet, it, xvi. c. 1. It is impossible not to see that the
gastric juice is alluded to in these passages. It is particularly stated of Ascle-
piadesy that he held digestion to be the solution of the food. — See C. Aure-
lianus, i. 13. And that the ancients were aware that the stomach secretes
a fluid possessed of solvent properties, is put beyond a doubt, by the follow-
ing extract from the works of Haly Abbas. Speaking of the changes which
the food undergoes in the mouth and stomach, he says : — " Iramutantur cibi
in ore, retinenturque, et flegmati admiscetur quod digestum est, calorque ei
datur. Quod antem flegma hoc hujusmodi sit, signum nobis est quod im-
petigines et sarpedones curat, quedam maturat ulcera, scorpiones necat.
liac ergo de causa et in ore cibus immutatur. Sic et stoma'shus ipsum im-
mutat: ejus etenim circum amplectitur substantia, quasque habet imprimit
qualitates, immutaturque ipsius natural! calore cibus : Sed et quoniam cibus
ipse M eo flegmati admiscetur humidor Theor. iv. 3. The whole bearing
ai this passage, but more especially the last clause, puts it beyond a doubt,
that the process of digestion was supposed to be performed, in a certain
measure, by the solvent powers of a fluid secreted in the stomach. And the
ingenious Alexander Aphrodisieus, in like manner, treating of the digestion of
mustard, pepper, and other acrid substances, says decidedly, that their acri-
mony is dissolved in the copious fluid of the stomach. Frohl. i. 30. — See
also Macrobius, Saturnalia^ lib. vii. 8. He calls it ventralis humor. Part
of the process was, no doubt, supposed to be performed indirectly by heat ;
and deservedly, for even Spallanzani was compelled to admit, that the com-
parative temperature of animals exerts a considerable influence on their di-
gestive powers. Hence, as was stated by Averrhoes, and as is confirmed by
Cuvier, birds, which are the warmest class of animals, likewise digest the
fiutest. At all events, the ancients were well aware, that digestion is not a
mechanical, but a vital process, being performed by the principle of life.
*^ Digestion,'' says Averrhoes, '' is performed by concoction, and the concoc-
tion is influenced by heat, not that the first mover in the operation is heat,
but the nutritive soul ; because the operations of heat are indeterminate, and
not directed to any manifest end.*' Celliget. v. 3. In the AverroeanOf or
XiCtters from Averrhoes to Metrodorus, the doctrine of a gastric menstruam
is discussed with singular ability. Metrodorus states, that ^ he found by the
Wfitings of the physicians and philosophers of these times, that they make
the menstruum^ as they call it, whereby both appetite is provoked, and food
in the stomach is digested, to be a certain juice or humour in the stomach,"
&c. Averrhoes denies that this menstruum acts by its acidity alone.
LXy.--*-ON THE CHARACTBR8 OF THE LUNOS.
The ancients were of opinion, that the lungs are an accessory organ, made
to administer to the heart. ^ It is the heart," says Aretseus, ^ which imparts
to the lungs the desire of drawing in cold air.'' They, of course, were aware
that respiration is the functional office performed by the lungs ; and, respecting
the uses of this vital process, they were pretty much agreed. Aristotle, in-
deed, and the older physiologists taught, that refrigeration is the purpose of
respiration ; but Gralen explains, that, probably, they were at a loss for a pro-
per term, and used it in the sense of ventilation. Galen, himself, perpetually
inculcates, that, by respiration the vital heat is regulated, being increased or
diminished according to the circumstances of the animal. Another purpose,
which he, Haly Abbas, and other ancient physiologists supposed to be per-
formed by respiration, is the evacuation of the fuliginous vapours of the
blood. Galen was awai'e that respiration produces the same efifect upon at-
mospherical air that combustion does, and that it is equally necessary to the
COMMKIITART ON THK PIEMT BOOK. 91
one proceis and the other.— See the treatises of Aristotle and Galen on re-
SiratioDy and Haly Abbas, ThearUa, lib. iii. The following extract from
aly contains the summary of what we have been stating:-—*^ Respiration
is necessary, for the sake of the heart, which is the fountain, and, as it were,
the focus of vital heat, whence it is diffused over the rest of the body. It re-
quires some aerial substance to ventilate the heat and ebullition of the heart,
and in order to evacuate the fuliginous vapours which are found in it.*'
LXVI.— ON THB TBMPBmAMBNTB OF THB HBART.
Im the ancient system of physiolosy, the heart was considered as the seat
of the vital powers, its office being die preservation of the innate heat of die
body. The philosopher, Aristotle, had pointed out the connexion between
Iieat and vitality, and had taught that the heart, as being the centre of heat,
is the prime organ in the animal frame. Hence, as his commentator, Averr-
boes, remarks, it is the primum movent et tUtimum moriens, Galen, however,
maintained with Hippocrates, that the animal frame is a circle, having neither
beginning nor end, and that, consequently, it has no prime organ. He
taught that the brain does not, properly speaking, derive its powers from the
heurk, nor the heart from the brain ; but that these organs are mutually de-
pendent upon one another, the heart being indebted to the brain for sup-
plying the parts concerned in respiration with muscular energy, and the braiti
being indebted to the heart for its vital heat, without which it could not con-
tinue to be the vehicle of sensibility and motion. We have mentioned in
the preceding chapter, that the ancient physiologists looked upon respiration
as being a process similar to combustion. Agreeably to this idea, they com-
pare the hc«rt itself to a lamp, — its vital heat to the flame of the lamp, and
the blood to the oil which foeds the flame. — See Galenus, de Utu Respirathnit,
Alexander Aphrodisieus, Probl. i. 16.
The heart, then, was supposed to convey heat to all parts' of the body, by
means of the animal spirits incorporated with the blood in the arteries. Re-
specting the contents of the arteries, two hypotheses divided the ancient
schools of medicine. The first was that of the celebrated Erasistretus, who
maintained, that the arteries do not contain a fluid, but merely certain airs
or vapours. This hypothesis was revived about 70 years aeo, by Professor
Rosa, in Italy; and lately it found a xealous abettor in my lamented friend,
Mr. George Kerr, of Aberdeen. The other hypothesis was that of Galen,
who keenly attacked this, as he did most of the tenets of Erasistratus, and
endeavoured to prove, by experiment, observation, and reasoning, that the
contents of the arteries is blood, mixed, indeed, with a certain proportion of
heat and airs, but in every respect a fluid, little difierent from that which is
contained in the veins. It was also part of his system, that the right cavity
of the heart attracts blood from the liver, and conveys it to the left, from
which it is diflbsed all over the body by the arteries. He taught that, at
every systole of the arteries, a certain portion of their contents is discharged at
their extremities, namely, by the exhalents and secretory vessels ; and that at
every diastole a corresponding supply is attracted flrom the heart. He de»
cidedly inculcates, that it is the expansion or diastole of the artery which oc-
casions the influx of the blood, and not the influx of the blood which occasions
the expansion of the artery. Though he demonstrated the anastamosis of
arteries and veins, he nowhere hints his belief, that the contents of the former
pass into the litter, to be conveyed back to the heart, and from it to be again
diffused over the body. Of the greater circulation of Harvey, he certainly
had no idea. In a word, his system appears to have been nearly, or alto-
gether, the same as that afterwards taught by the unfortunate Servetus.
92 COMMENTARY ON THB FIRST BOOK«
In proof of the opinioDs which I have attributed to Galen, I refer the
reader to An Natura Sariguinis sit in Arteriis, Administ, Anatom, vii. 15, de
Vsu Partium, lib. vi. and lib. vii. 7, 8, 9, de Placitis Hippocr, et Plat. i. 5.
See also Averrhoes, Colliget. ii. 8. ii. 9. Collect. § i. 9. In Cant. Avic.
tr. i. p. 1. — Avicenna, lib. iii. fen. xi. tr. 1. — Actuarius, (/e Spiritu Animali^ p.
i» § 6. c2e Causis Urinarumj ii. 2. — Nemesius, de Natura Hominis, § 24.
With regard to the passages collected by the ingenious M. Dutens, fix>m
the works of Hippocrates, Plato, Nemesius, Pollux, and Theodoret, to prove
that the ancients were acquainted with the circulation of the blood, as taught
by Harvey, I shall only remark, that, after having attentively considered then),
I cannot but draw the conclusion, that some of these authors must have had,
^t least, an obscure idea of this doctrine, although, in general, these passages
paay be understood to refer merely to the lesser circulation and the move-
meut of the blood from the centre to the extremities, as maintained by Oalen.
— See Dutens, Origine des Decouvertes attributes aux ModemeSy p. 157, —
also Drelincurtius, de Lienosis Epimetris.
LXVII. ON THE TEMPERAMENTS OF THE LIVER.
AccoRDiKG to the views of the ancient Physiologists, the liver is the seat
of the natural powers, being the grand organ of sanguification, and the blood
being the pabulum which nourishes the whole body. That the liver per-
forms an important part in the fabrication of the blood, seems probable from
all the veins of the stomach and upper* portion of the intestines passing
to th^ liver, whereby it is to be supposed, that a considerable proportion of
the nutiitive juices will be conveyed to it ; and from this viscus being pro-
portionally large in the fcetus when it is much required to form blood, and
cannot be supposed necessary for any other purpose. In fact, the late ex-
periments of Professors Tiedeman and Groelin seem to prove, that the liver
IS concerned in carrying off the recrementitious part of the blood, or, to use
the language of modem chemistry, in decarbonising it. Recherches Exper.
sur la Digestion. The ancients taught, that the liver, by its attractive power,
attracts the chyle from the stomach ; that, by its retentive, it retains the same
until the alterative convert it into blood ; and then the expulsive separates
the superfluities of the blood, namely, the bile, and conveys them to the gall-
bladder.— See Galenus, tom. ii. p. 285. Ed, Basil, and Avicenna^ lib. iti.
fen. 4. tr. 1.
Aristotle held that the spleen is part of the hepatic system, de Partibm
Animal, iii. 7. His commentator, Averrhoes, in like manner, considers the
spleen as a second liver. Collect, i. 9. Their reasoning, on this point, ap-
pears to me exceedingly acute and conclusive.
LXVIII. ON THE TEMPERAMENTS OF THB TESTICLES;
The testicles were described by the ancient anatomists as being bodies
xomposed of white glandular flesh, and surrounded by coats which they
Jcnew to be processes of the peritoneum. The semen they considered as a
white frothy fluid, elaborated from the blood, by passing through the convo-
lutions of tne spermatic vessels. Aristotle held it to be a superfluity collected
from all parts of the system. His theory of generation is similar to that of
Buffon. For the hypothesis of the Epicureans, see Lucretius, de R. N. lib.
iv. They taught that the foetus is the joint-production of the male semen, and
something analogous secreted by the ovaria of the female.
COMMSNTART ON THB FIRST BOOK. 93
LXIX. — ON THR PARTS WHICH ARS OMITTRD.
On these consult Galenus, de Temperameniis. — Haly Abbas, Tkeor. iii.—
Avicenna, lib. i. fen. 1. doct. 3. We may mention that, generally speaking,
all those parts which possess much blood were supposed to be of a not tern*-
peramenty and those which baTe little of a cold.
LXX. ON THR CURR OF THR HOT INTRMPRRAMRNT8 OF THR BOOT*
See in like manner Galeous, de Sanitate Tuendoj lib. vi. — Oribasius, Syn:
V. 51. — Aetius, iv. 95. — ^Actuarius, de DUBta, c. 12.— *Of the Arabians, Haly
Abbas is the author who has delivered the treatment of the temperaments in
the fullest manner, Pract, i. 15.
It is ta be remarked, that the condition of the body named the hot intern^
perament by the ancients is the same as that now generally called a bilious
habit. Accordingly, Galen directs the physician to attend whether any pain
or sense of weight be felt in the region of the liver, as, in that case, he judges
it unsafe to take the bath after a meal, and recommends rather to give deob*
straents, and to avoid food of a thick viscid nature. He particularly recom-
mends an attenuant diet, and medicines of the same description, namely,
wormwood, anise, bitter almonds, &c. His views of practice in this case
appear to bave been very judicious.
LXXI.— ON THR CURR OF THR COLD INTRMPRRAMRNT8.
See the authorities referred to in the preceding chapter. All, in a wordj
copy from Galen.
LXXIl. OF THR CURR OF THR DRY INTRMPRRAMBNTS.
Galen supplies all the matter of this chapter.
This being me last chapter in which the temperaments are treated of, it
maybe interesting,- before concluding with them, to give a brief exposition of
modem opinions on this subject. We shall select the account of them given
by Dr. CuUen in his work on the Materia Medica. He says, ''The ancients
very early established a distinction of temperaments, which the schools of
physic have almost universally adopted ever since, and appears to me to be
founded in observation.*^ He then proceeds to describe what he calls the
four temperaments, namely, the sanguine, the melancholic, the choleric, and
the phlegmatic. In the sanguine, he says, the hair is soft, and never much
nurled, is of a pale colour, and, from thence, passing through the different
shades to red ; the skin is smooth and white ; the complexion ruddy ; the
eyes commonly blue; the habit of the body soft and plump; after the period
of manhood, disposed to obesity, and at all times readily sweating upon ex-*
ercise ; the strength of the whole body moderate ; and the mind sensible,
irritable, cheerful, and unsteady. This, he says, is the tentperamentum calidum
et humidum of the ancients. He adds, the other temperament distinguished
by the ancients, which I can characterise most distinctly, and explain most
clearly, is, that which has been very constantly named the melancholic. The
hair is hard, black, and curled ; die skin is coarser, and of a dun colour,
with a corresponding complexion ; the eyes very constantly black ; the habit
of the body rather hard and meagre ; the strength considerable ; the mind
94 COMMENTARY ON THB FIRST BOOK«
slow, disposed to gravity, caution, and timidity, with little sensibility or irri-
tability, but tenacious of all emotions once excited, and, therefore of a great
steadiness. This, he says, the ancients made the temperamentumfrigidum et
tkcum. A temperament intermediate between the sanguine and the melan-
cholic, is the one which the ancients meant to denote by the title of choleric,
which has more strength than the sanguine, and more irritability than the
melancholic. In the phlegmatic, there are less sensibility and irritability,
but with more strength and steadiness than in the sanguine ; and, at the
same time, with more laxity and more irritability than in the melancholic.
Such is Dr. Cullen's description of the temperaments, which, as must be ob-
vious to the reader, contains a very erroneous account of the ancient doctrines
on this subject.
The modern ideas respecting the temperaments, appear to be founded
upon the descriptions given by the Arabians of the symptoms, which charac-
terise the prevalence of the four humours, as they were called, namely, blood,
yellow bile, black bile, and phlegm, in the body. In proof of this, I sub-,
join Rhases' brief description of them : — '^ De complexione autem infirm!
scias, quod si fuerit albi coloris admixti rubedini, et si fuerit bone camis,
subtilis cutis, et quando locum fricaveris, rubescit statim, significatur quod
materia est sanguinea. £t si corpus fuerit pingue, et albi coloris non mixti
rubedini, et corpus nudum pilis, venb strictis, came molli, occultarum juDC-
turarum, gracilium ossinm, et generaliter talis dispositio qualis est in corpo*
ribus muUerum, significatur quod materia est pnlegmatiea. £t si fuerit
macrum, citrini coloris, pilosum, et cum crassis venis, et manifestis junctu-
ris, ostendit quod materia est cholerica. £t si fuerit niger color, durities cor-
poris, pilositas, asperitas cutis, significatur quod materia est melancholica." —
Ve Affect, Junet, c. 2.
It is to be understood, however, that Galen's system of the temperaments
was not based, as has been often erroneously represented, upon any hypo-
thesis respecting the humours.
LXXIII.-^ON THB PB0PBETIB8 OF FOOD.
The ancient writers on Dietetics are, Hippocrates, de Diata, de Affectioni-
bui, et alibi. — Celsus, lib. ii. — Dioscorides, Mater, Med. lib. ii.—^alenus,
de Faeult, Alim, et, de Probis Pravisgue Aliment, Sw, Oribasius, Med. Col-
lect, lib. i. et seq. — ^Aetius, lib. iiw^-Simeon Seth, de Alimentis, — Actuarius,
de Spiritu Animaliy p. ii.— Rhases, ad Mamor, lib. iii. Continent, lib.
xxxiii. — Avicenna, Cantic, p. ii. Averrhoes, Comment, de Cantic. — Haly^
Abbas, Theor, v. 15. — ^Athenseus, Deipnot. panim, Plutarchus, de Sanitate
Tuenda, Symposiacon, — Macrobius, Satumal. lib. vii. — Cslius Apiciusy de
Opsoniit, — Geoponicny lib. xii.
The ancient philosophers were at great pains to explain why a regular
supply of food IS necessary to the existence of animals. On this su^ect,
Timeus Locrus, Plato, and Aristotle, have philosophised with great acute-
ness and ingenuity. No one, however, has given a plainer account of the
matter than the Poet Lucretius in the following verses : —
** lUnd Hem non est mirandum, corporis ipsa
Quod natura cibum quierit quoifisqae nni mantis \
Ctuippe etenim fluere, atque recedere corpora rebus
Mnlta modis multis docoi, sed plurima debent
Ez animalibus lis, qus sunt exerdta motu ;
Multaqne per sudorem ex alto pressa fenmtur,
Malta por os e^dialantiir^ qaom laagoida anhelant :
Hit igitar rebus raresdt corpus ; etomnis
OOMMBNTART ON TUB FIRST BOOK. 95
Subrnitar natnra dolor quam consequitur rem.
Propterea Cfq>itiir dbufl, ut suifalceat artas,
£t recreat yins interdatasi atque patentem
Per membra ac Tenas vt amorem obtnret edendi."
De Renm Ntt, W. 1. 866.
The explanation given by one of Rbases's authorities is to the same effect.
He says — '^ Since our bodies are in a continual state of waste from the sur-
rounding atmosphere, and the innate heat which is within, it behoved them to
have nourishment to supply the part which is melted down ; and, as all the
food which is taken is not assimilated, it was necessary that there should be
passages for the discharge of the superiSuities."
Hippocrates, Aristotle, Galen, and Musonius (ap. Stobci Sentent» s. 18.)
remark that the stomach is to animals what the earth is to vegetables.
Our author's general remarks on the properties of food are condensed from
Galen's work, l)e Prob. p. AL tuc, Horace agrees with Galen and our
author in condemning the mixture of various articles of food, Satir, lib. ii. s. 2.
The arguments for and against this practice are very ingeniously stated by
Macrobius, Saturn, vii. 5, 6. It appears that Asclepiades maintained the opi-
nion that a multifarious diet is most easily digestea. Celsus, iii. 6.
With regard to the ordinary meals of the ancients, the following extract
from the notes of Lambinius on Plautus will supply the necessary informa-
tion:— ^^Jentaculum primus erat cibus apud Komanos ut apud Gnecos
oKpaTurfjui; quem sequebatur PranJium ; deinde Vesnerna; postremo Cana:
apud Graecos dpurrov, deinde i<nr€purfjLaf postremo oeiirpovJ* Truculent. Ac.
ii. sc. 7. I. 38. See also Athenaeus, Deipnos. lib. 1. and Potter's Archaohgia
Graca^ lib. iv. 16. The practice, however, of taking so many meab, appears
to have been disapproved of by the physicians and savam : mr we find Actn-
arius discussing the question, whether it be proper to eat twice, or only once
Id the day; and Galen decidedly recommends not to take food in general
oftener than twice. Cicero even forbids to take two fiill meals in a day. (Tup-
cuL Quasi, lib. v.) Haly Abbas enters into a full examination of the question
with regard to the numoer of meals. Some, he says, eat only once in the day,
some twice, and others three times. He advises those persons who are ac-
tively employed not to dine, because, if obliged to take exercise immediately
afterwards, the body will be loaded with half concocted chyle. Upon the
whole he prefers supper to dinner. Pract. i. 13. Alsaharavius considers one
meal in the day not sufficient for persons of a gross habit of body. He ad-
vises not to change even a bad regimen too suddenly. Rhases remarks, that
to take another supply of food before a preceding meal is digested, will provt
highly prejudicial to the health.
The ancient physicians attached extreme importance to the proper regu-
lation of the diet. Galen seriously admonishes his readers not to eat
thoughtlessly, like brute beasts, but to consider attentively what kinds of food
and drink they find from experience to be prejudicial to them. De Sanitate
Tuenduy lib. vi. 13.
According to Athenaeus, a good physician ought to be a good cook. —
Deipnos. lib. vii.
LXXrV. ON POT'HBRBS.
Athemjeus remarks that the use of pot-herbs as articles of food appears to
have been very ancient, since several of them are mentioned by Homer.
Det/mo«. i. 29. Diphylus says, '' that all pot4ierbs in general contain little
nutriment, are attenuant, engender bad juices, swim in the stomach, and are
of difficult digestion." Deipnos. ii. 28. Actuarius states, that pot-herbs in
)
96 COMUBNTART ON THE FIRST BOOK.
general form a thin and watery blood, compared with that from thicker arti-
cles of food.
The ancients ate their pot-herbs with much oil, and generally a liberal al-
lowance of hot spices. See Apicius, lib. iii. A sauce from pickled fish,
vinegar, or old wine, was often a^ded to the preparation. The poet Juvenal
makes mention of a miser who ate his cabbage with the oil from lamps.
Sat, V. 1. 87. Celsus remarks of such things, " Quodcunque ex olio garove
estur olus alien um stomacho est.*'
We shall now select from the dietetical writers a few remarks on some of
the articles of this class :
Galen strongly commends the Lettuce as a cooling, moistening, and
soporific herb. He relates that he cured himself of morbid insomnolency,
by eating liberally of lettuces. The soporific property of lettuce is men-
tioned by Dioscorides, Pliny, Athensus, Rhases, Haly Abbas, Simeon Seth,
and most of the other authorities. It is even said by Simeon Seth, and Flo-
rentmus {Geopon. xvii. 13.), that the juice of it when rubbed upon the fore-
head induces sleep. 1 need scarcely remark, that the lettuce was lately re-
stored to its place in the Meteria Medica as a soporific. Martial directs to
eat lettuce at the beginning of a feast. Lib. xi. £p. .53.
Athenseus mentions that Mallows are praised by the poet Hesiod,
{Op, et Dies. lib. i.) He adds, *< Diphilus relates that mallows have good
juices, smooth the trachea, are easily evacuated, and prove moderately nutri-
tious.'' Damogeron says that, when eaten with nsh-sauce and oil, they
loosen the belly. Geopon. u. s. Galen and Aetius state that they lubricate
the intestines more than lettuce, but are not so refrigerant. In a word,
mallows were in great repute with the ancients as being inferior to none of
olera. Horace calls them, " gravi malvae salubres corpori," Epod. ii. The
poet Martial mentions them as being laxative. Lib. x.
Galen states, that the juice of the Beet is thinner and more detergent than
those of the lettuce and mallows. He says that, when twice boiled, it be-
comes astringent. Apicius recommends to eat boiled beet with mustard, a
moderate proportion of oil, and vinegar. Beet-root, according to Actuarius
and Simeon Seth, is difficult to digest, flatulent, and laxative. Dioscorides
and Diphilus, however, state, that beet contains better juices, and is more
nutritious than cabbage. Athen. Deipn, ix. Galen recommends its pickled
roots as a deobstruent for infarction of the liver and spleen. De Alim. Fa-
cult, lib. ii.
The wild Succory, and the Endive or garden Succory, were much used by
the ancients as pot-herbs. Galen briefly states, that in properties they re-
semble lettuce, but are less delicious. According to Simeon Seth, they are
slightly cooling and moistening. The endive, he says, when boiled with
vinegar, is astringent. Rhases praises it as a deobstruent in aflections of the
liver. Apicius directs to dress them with fish-sauce and oil. Its boiled
roots were also prepared as a pickle.
The Brassicae or Cabbages were great fevourites of the Elder Cato. De He
lUat, Horace states correctly, that such as grow in the country are better
than those which are raised about towns. Sat, ii. 4. According to Galen,
their juices are laxative, but their solid parts astringent. Brocoli, says
Rhases, when not pickled, are not heating, and being flatulent they engender
semen. Those that are pickled are more heating, occasion thirst, supply bad
nutriment, and inflame the blood. Is Brocoli an Italian word, or an Arabian,
formed from caulis with a prefix ?
The Halimus, according to Sprengel, is undoubtedly ihe Atriphx Halimut
L. called by Miller the Sea Purslane, Dioscorides says, that its leaves when
boiled are used for food, lib. i. 120.
COMMENTARY ON THE FIRST BOOK. 97
Rhases and Haly Abbas state, that Spinage is laxative and wholesome.
The Greeks and Romans appear to have l>een unacauainted with it.
The Atractylis is supposed by Sprengel to be the Carlina Lanata L. Dios-
corides and Pliny recommend it as an antidote against poisons ; but it seems
to have been little used as a pot-herb.
The Scandix, or Shepherd's Needle, was in little repute as an article of
food ; and hence Aristophanes makes it a subject of reproach to Euripides,
.that his mother sold not good pot-herbs, but Scandix. Achar, act. ii. sc. 4.
Plinius, If. N, xxii. 38.
Galen says, that the Gingidium is eaten in Syria, like the Scandix in his
country. It has been supposed to be the Chsrophyllum or Chervil ; but, ac-
cording to Ludovicus Nonnius, this is a mistake.
Galen, Aetius, and Simeon Seth, speak of the Artichoke as an unwhole-
some pot-herb. It may be eaten, however, Galen says, with oil, fish-sauce,
and wme and coriander. Dioscorides says, that the Scolymus is eaten Kke
asparagus. lib. iii. 16.
The Hipposelinum appears to have been the Sm^mium Olusatrum. — Sec
Harduin's note on Pliny, If. N, xix. 48. and Sprengel, ap, Dioscor, iii. 71 .
Dioscorides says, it is used as a pot-herb like parsley, its root being eaten
boiled or raw, and its stalk and leaves boiled, either aloue or with fish.
It is not to be coniounded with the Smyniium of the ancients. Dioscorides
says, thai the latter, when pickled, is used as a pot-herb, and is astringent.
Galen says, that the Blite and Orache are watery pot-herbs, and almost in-
sipid. Seth, and the other authorities who notice it, agree, that the latter is
coolii^ and laxative. The Blite is still much used as a pot-herb in Spain and
Italy,
Xenophon mentions, that the ancient Persians lived very much upon
Cresses. Cyroped, i. 2. According to Aetius and Simeon Seth, they are cale-
iacient and desiccative. Seth calls them aphrodisiacal. On the aphrodisia-
calpoiiers of the Cresses and Rocket, see Chapter 36th.
Dioscorides says, that the root of the Dracunculus, or Dragon herb, is some-
times eaten as a pot-herb, both when boiled and raw. He mentions, that the
inhabitants of the Balearian Isles mix its root with honey, and use it at their
banquets in place of cakes. Lib. ii. 16. Simeon Seth notices it by the name
of Taichon, being a corruption from Tarragona. He calls it flatulent and un-
wholesome ; and says, that its leaves only are to be used along with mint
and parsley. Galen and Rhases likewise mention it as an article of food. It
is still used on the Continent for salads, and an excellent pickle from it is
brought to this country.
Mustard, as Hippocrates remarks, is of a hot and purgative nature. Seth
says, that it promotes the digestion and distribution of the food. Rhases for-
bids to eat it, except along vrith thick articles of food.
Pliny mentions the Ocymum or Basil in very unfavourable terms.
Cappers, say Aetius and Seth, consist of different qualities, as bitterness,
whidi renders them detergent, purgative, and penetrative; acrimony, which
makes them calefacient, discutient, and attenuant ; and sourness, which ren-
ders them astringent. Serapion says that, when pickled with vinegar, they
strengthen the stomach, and whet the appetite. When pickled with salt, he
says, they are bad for the stomach. Galen recommends pickled cappers in
ot)structioii of the Liver and Spleen.
The Bouglossum, or Borage, is frequently mentioned as a herb, which,
when eaten, imparts gladness to the soul. Ludovicus Nonnius informs us,
that the Belgians still fancy that it possesses this property, and look upon
it as the Homeric Nepenthes.
We have had occasion to mention in another place, that the ancients were
fully persuaded of the aphrodisiacal properties of the Eruca, or Rocket.
n
98 COMUBNTARY ON THE FIRST BOOK.
LXXV. ON ASPARAGI, OR YOUNG SHOOTS.
<' Asparagus. The first sprigs of Herbs before unfolded unto leaves, and the
youngest and tenderest branches that are eatable, are called Asparagus/'
Miller's Gardener*s Dictionary, — See also Suidas in VocCy Galenus de Alim.
Facult. Humelbergius, ap. Apul. de Med. Hist. c. 84. Our authofs ac-
count of the Asparagi is aoridged from Galen. He remarks, that the young
shoots of the cabbage, called Cymae, are particularly tender. Apicius di-
rects to prepare them with cumin, salt, old wine, and oil ; to which pepper,
borage, and the like may be added.
On the Asparagi, see Athenseus, Deipn, lib. ii.
The Plant now commonly known by the name of Asparagus or Sparrow-
grass, is said by Simeon Seth to be so nutritious, that it deserves to hold an
intermediate place between pot-herbs and flesh. He remarks, that it is diu-
retic, and imparts its smell to the urine. The wild Asparagus is called
Corruda'by Cato, Columella, and Pliny.
LXXVI. ON HERBS HAVING ESCULENT ROOTS.
Galen thus delivers the general character of these substances: "The
roots of Pot-herbs which are acrid, such as those of onions, leeks, garlic,
radish, and carrot, contain bad juices ; but those of turnips, rapes, and cara-
ways, hold an intermediate place between things of good and of bad juices.'*
It is well known, that the Romans had two kinds of Herbs with esculent
roots called the Napus and Rapum, and that they are generally admitted to
have been two species of the Turnip. — See Columella, ii. 10. — ^Pliny, H. N.
Yviii. 13, and the note of Harduin. — Dickson's Husbandry of the Ancients,
c. 33. — Sprengel, R. H. H vol. i. The term Bunias occurs first in Nican-
der; and that it was synonymous with the Gongylis, is declared by Galen
and our author ; and, further, that it was the Brassica Napobrassicu L, is
admitted by all the late authorities on classical botany, with the exception of
Dierbach, who most unaccountably contends, that it is the B. Oleracea,
Galen says that, unless well boiled, it is~ indigestible, flatulent, and bad for
the stomach. Seth assigns it the same qualities as our author. All account
it diuretic and aphrodisiacal. Apicius directs to eat the Rapa or Napi with
cumin, rue, vinegar, oil,&c. Lib. iii. c.fS. — It appears from Athensus, that
the ancients frequently ate their Turnips roasted.
It is not well ascertained what the Esculent Bulbi of the ancients were.
Harduin conjectures that they were a delicious kind of onions. Matthiolus
and Nonnius are wholly undecided. Sprengel inclines with Dalecampius
and Sibthorp to think that they were a species of Muscari, or Musk Hyacinth.
The account of them given by Serapion, who calls them Cf/pa sine tunicis,
agrees better with the conjecture of Harduin. Eustathius likewise says, that
the Bulbus was a wild onion. Ap, Iliad, xiii. 589. Columella calls them
aphrodisiacal. Lib. x.
The Staphylinus was unquestionably the Carrot. Apicius, among other
methods of dressing it, directs to do it with salt, pure oil, and vinegar.
The Carus seems indisputably to have been the Carum Carui L. Dios-
corides says, that its boiled root may be eaten like the Carrot. Seth praises
it as being carminative, diuretic, and astringent. Apicius mentions it fre-
quently along with spices and other aromatics.
The characters of the onion, garlic, and leeks are taken from Galen. Cel-
sus calls them calefacient, and ranks them with things having unwholesome
juices. We have mentioned, in another place, that the Scotch Highlander
COUMBNTARY ON THB F1&8T BOOK. 99
eats ODioDS to enable him to support the fatigues of a journey. Dr. Paris
considers this a proof that they are very nutritive, but I am disposed to
think, with the ancient authorities, that they are merely hot stimulants. Ac-
tuarius prefers the leek to the onion and garlic. The latter is warmly
eulogised by Gralen as being the rustic's Theriac. Horace had not so much
^voor for it. Epod, iii. Galen calls the Ampeloprason the same as the
wild LedL. De Fac, Simp, vi. Dioscorides descnbes two species of the
Pormm, namely the Capitatum and Sectivum.
Galen directs to eat Kadish before dinner. He justly expresses his sur-
prise at the practice of certain physicians, and other persons of his time,
who ate Radish after dinner to promote digestion. The wild Radish was
called Armoraciab^ the Romans.
LXXVII.— ON MUBHROOMS AND TRUPFLB8.
DiPHiLUs says, ^ that Fungi are grateitil to the stomach, laxative, and
nutritious, but of difficult digestion and flatulent.'' Athen. Deipnos. ii. 19.
Diphilus says '' that the nature of Truffles is, that they are difficult to digest,
supply goodjuices, and are laxative ; but that some of them like the Fungi
occasion suffocation." Ibid. c. 51. Galen says, that they contain cold,
viscid, and thick juices. Serapion says, that they engender gross humours.
According to Avicenna, they are apt to superinduce Apoplexy and Pa-
ralysis. Simeon Seth says, that Truffles occasion cruae and depraved
humours. He directs to allow them to steep in water for some hours oefore
boiling them ; and to prepare them with pepper, marjoram, salt, and rue, to
collect their bad properties. Rhases, in like manner, recommends to eat
Truffle boiled in water with salt, marjoram, oil, and assafatida. He advises
to take wine, honied water, or the Theriac, after Mushrooms. Apicius
directs to eat Fungi with pepper, oil, salt, &c. Horace points out the best
Idnd of Fungi :
^* Pratensibiis optima fungia
Natora est : alus male creditur.*' — SaL ii. 4«
The poets make frequent mention of Mushrooms as a delicacy at the
tables of Gourmands. — See in particular Juvenal, Sat, v. 145.
Apicius directs to preserve Truffles, by laying them in a vessel along with
akemate layers of saw-dust, and then covering up the mouth of the vessel
with paicet. On the mode of raising them, see Geopon, xii. 41. In the
days of Juvenal, the Roman Gourmands appear to have attached more im-
portance to the Tribes than the com which they were supplied with from
Africa:
'' TiU habe fromentom, Alledius iaqiiit,
O Lybie ; diiyuiige boves dum tubera mittas.*' — Sat, v. v. 116.
In a celebrated modem woric the Truffle is called : << Un tubercule qu'
en ne peut mettre dans la classe des legumes ni des fruits." — Aim, de$
GourmamdSf vol. viii. p. 4.
Ludovicus Nonnius confesses himself unable to determine what species of
Mushroom the Amanitas of our author were. Seth makes no distinction be-
tween them and the Mycetse.
LXXVIII. — ON THB FRUMENTACEA.
On the Ceiealia consult in particular Theophrastus, If. P. lib. iii.
Dioscorides,^ lib. ii. GalenHs, de Aliment^ lib. i. Plinius, If. N, lib. xviii.
SerapioB, de Simpl, Harduin, Nota in Plin. I. c. Paucton, Metrologies
h2
100 COMMENTARY ON TH£ FIRST BOOK.
Dickson*s Husb, of the Ancients. Sprengel, R. H, H. and Nota in Dioscan
I. c. and Ludovicus Nonnius, de Re Cibaria, lib. i.
AmoDg the Cerealia^ Wheat, as Galen states, deservedly holds the first
place, as being in most general use, and containing the most nutriment
within a small bulk. He remarks, that it is the most glutinous of all the
articles of this class. And here, by the way, I must beg leave to dispute
the correctness of Dr. Cullen*s statement, that Beccaria of Bologna, about
the year 1728, first discovered that Wheat contains a glutinous matter.
Haly Abbas likewise states, that Wheat is the most nutritious of all arti-
cles of food. Pliny asserts the same thing of it. He calls the Siligo the
delicia tritici, Galen explains the Siligo and Similago in much the same
terms as our author. The third species, or the AutopyruSy he says, consists
of all the parts of the grain, the bran not being excluded. Actuarius, on the
other hand, says that the bran only is rejected. Is not the text of the latter
corrupt ? Bran, Galen adds, is detergent and contains little nourishment.
Tryphon, in Athenaeus* Deipnosophista, states, tliat this thirjd kind of Flour
is the most laxative.
Theophrastus mentions that the lightest Wheat imported to Greece in his time
was the Pontic. It is curious to remark, that Odessa Wheat still retains its
ancient character. The heaviest, he says, was the Sicilian, which, however,
was lighter than the Bsotian. Pliny says, that the lightest Wheat brought
to the Roman market was the Gallic, and then that imported from the Cherso-
nese. The first in excellence, he adds, are the Baeotiau, the Sicilian, and
next to these the African.
Galen gives an interesting account of Bread. The best kinds, he says,
are such as contain plenty of yeast, have been properly pounded, and exposed
to a moderate heat in the oven. When exposed to too strong a heat, be
properly remarks, that a crust is burned on the outside, while the inside is
left raw or improperly concocted. Unleavened bread he wholly condemns.
Celsus appears to have had a better opinion of it, for he ranks it first among,
those substances which do not spoil on the stomach. Of bread in general,
he correctly remarks, ^' Siquidem plus alimenti est in pane quam in ullo
alio.*' Pliny and Galen describe a soft spongy kind of bread, which would
seem to have resembled that which the common people in Scotland call
Bunns. Pliny adds, that some nations prepare their bread with butter. He
mentions a sort of bread called Artolagani, which, according to Dr. Arbuth-
not, answered to our Cakes. Seth gives an interesting account of bread;
but it is mostly extracted from Galen. Haly Abbas says, that the best kind
of bread is that which is made from wheaten flour and salt, and is fermented^
and heated in an oven to such a degree as not to burn the outer-crust. Rhasea
disapproves entirely of unleavened bread. Serapion states that old bread
is astringent. Avenzoar properly prefers newly-made bread, provided it has
been cooled. According to Actuarius, the lightest kinds of Wheat form the
best bread for indolent persons, but persons actively employed require the
weightiest kinds. Unleavened bread, he says, is very indigestible. Breads
prepared with oil, he adds, is very nutritious, but requires a strong stomach
to digest it. See an interesting account of the various kinds of bread in
Athenaeus, Deipnos, lib. ii.
The Zea, Typha, and Olyra of the Greeks, and the Far and Adoreum of
the Romans, were all varieties of Spelt, a species of grain bearing some re-
semblance to wheat. Actuarius calls it a lignt, and not very nutritious grain.
The Chondrus was prepared from Spelt, by first separating the husk, and
then breaking it down into granules. The Alica was the same as the Chon-
drus^ with only the addition of a small quantity of chalk ; and, indeed, al-
most all the writers on Dietetics, except our author, use them as synonymous
terms. A more complicated method of preparing them is described by Pliny,
COMMENTARY ON TUE FIRST BOOK. 101
N
and in tlie Geoponics, lib. iii.7. Sprengel says that Chondrus is called Perl*
graupen by the Germans. Galen, like our author, explains that a gruel, or de-
coction from it, is unwholesome, as it thickens before it is properly concocted.
Starch, according to Galen and Oribasius, is lubricant, and not calefacient
like bread. They say that it is not very nutritious. Serapion gives the same
account of it.
Galen, Hhases, Haly Abbas, and, in fact, 1 believe, all the authorities, agree
that Barley is of a colder nature, and less nutritions than wheat. Polenta was
prepared, by first steeping the grain in water, and afterwards drying it at the
fire, and grinding it down to meal. It was therefore a sort of malt. Galen,
like our author, remarks that Barley-meal sprinkled on wine and water, or
water alone, makes an excellent beverage. Actuarius recommends Barley
water as a diluent drink in Fevers. Ptisan of barley was thus prepared : —
Barley was boiled until it swelled; it was then dried in the sun, and af-
terwards pounded, and freed of its husk, and again pounded, but not ground.
This Flour was boiled with fifteen parts of water, to which a small quantity
of oil, and, when it swelled, some vinegar were added. Salt also was often
added to it. See Galen*s treatise de Ptisana. A long-lived race of people in
Chaldea are said to have subsisted principally upon Barley bread. V. Lu-
ciani Macrohii,
GaleD says of Oats that they are the food of horses and not of men. One
would almost fancy that Dr. Johnson bad stolen his definition of Oats from
him ! Aetlus and Simeon Seth call them refrigerant.
Galen, Dioscorides, Simeon Seth, and Serapion, agree that Rice is astrin-
gent, and recommend it for ulcers of the Intestines. Simeon Seth calls it
nutritioos.
Galen and Serapion say that Millet and Panic, being devoid of oily matter,
are desiccative, and therefore useful in defluxions of the belly. Simeon Seth
says that the Millet is of dilficnlt digestion, and not nutritious. Rhases di-
rects to eat Panic with fresh milk, butter, and sugar. Pliny mentions a sweet
species of Bread prepared from Millet. Galen says that it is not possessed
of much nourishment.
The Maza, as Zeunius explains it, consisted of the flour of toasted barley
ponnded with some liquor, such as water, oil, milk, oxycrate, oxymel, or
honied water. Galen calls it flatulent and unwholesome food. Hesiod re-
commends the Maza, or Cake prepared with milk, as an article of food during
the beat of the Dog-days. Opera et Dki, 1. 588.
The Bellaria, called also Placentte, Liba, and Crustulae, by the Romans,
and by the Greeks irffifmra and Irpia, were Cakes of various kinds, prepared
with flour, water, oil, honey, and sometimes fruits. See Athenseus, Deipnos.
xiv. The ObcUu$ panis, mentioned by him in the 3d Book, is supposed by
Ludovicus Nonnius to have been a species of Pastry.
The Bticellatum mentioned by Ammianus Marcellinus, and ^lius Sparti-
anus, was a species of Bread used by the Roman soldiers, anfi appears to
have resembled our Ship-Biscuit. V. Not. Oronovii ap. Amm. Marcell.
xvii, 8.
LXXIX. ON THE LBGUMINA, OR PULSE.
Rhases, and other of the ancient authors remark, that Pulse in general
are nutritious. All held that they are flatulent, excrementitious, and
aphrodisiacal. According to Plutarch, it was on account of their aphro-
disiacal qualities that the Egyptian priests forbade the use of them. Some
assign this as the reason why Pythagoras — " ventri indulsit non omne legu-
men." Apollonius Dyscolus says that he did so because they are flatulenf,
102 COMMBNTART ON THE FIRST BOOK.
difficult to digest, and occasion disturbed dreams. Hist. Mir(^, c. 46. Thi9
seems the most likely reason ; but Plutarch, Jamblichus, and Porphyry, think
they see more recondite meanings in the Pythagorean interdiction. Actuarius
remarks that all kinds of Pulse are to be eaten in their green juicy state.
Galen speaks of Lentils in much the same terms as Paulus. He particu-
larly disapproves of the practice, which he says was common in his time, of
eating them with sodden wine. Rhases says that they are of a cold, desiccaf>
five, and excrementitious nature. Actuarius calls them the worst of the Le-
gumina. Athenaeus mentions that the Egyptians lived much upon Lentils.
Lib. iv.
All the commentators are puzzled to determine what the ancient Faba was.
L am inclined to think, with Dickson, that Theophrasius's description of it
applies best to our small bean. The Egyptian Bean, according to Sprengel,
was the Nelumbium Speciosum, Galen mentions that Beans were much used
by the Gladiators for giving them Flesh, but adds that it was not firm or
compact. Dr. Cullen, by the way, notices the nutritious qualities of these
tilings, but omits to mention that the Flesh which they form is deficient
in firmness. Actuarius states that they are nutritious, but dissuaides from
using them freely^ because of theif flatulence. Acconling to Celsus, both
Beans and Lentils are stronger food than Pease. Seth agrees with Galen^
that the Flesh formed from them is flabby and soft. Galen directs to fry
Beans, or boil them with onions, whereby they will be rendered less flatulent.
De Alim. Facult. lib. i.
All the authorities give Pease much the same characters as I^uilus does.
Galeft mentions the method of steeping Chiches in water, and getting them
to germinate before using them for food. Are the bons vivans of the piesent
day acquainted with this method of making Pease tender and soft? The an*
cients were also in the practice of prepaiing these seeds for sowing in much
the same manner. Geopon. ii. 36. See also Pliny, xviii; c. 13. I am in-
clined to think that Virgil alludes to this practice, Georg. i. 193 ; but Dr.
Hunter has put a different interpretation on this passage. It would appear
that the modern Egyptians eat Beans in the sprouting state, that is to s^^.
when beginning to germinate. See Assalini on the Plague, p. 106.
Khases properly remarks that Lupines, being bitter, are not properly arti-
cles of food, but medicines. They possess^ he adds, little nutriment. Galen
says that they are indigestible, sma therefore apt to engender crude humours.
When eaten, he directs to have them well sweetened.
Galen mentions that some took Fenugreek, with Fish-sauce, to open the
belly. He says it may be eaten with vinegar, wine^ fish-sauce, or oil. Some^
he adds, use them as a condiment to bread. Rhases gives similar directions
for using Fenugreek.
It is probable that the Faseolus was the Kidney-bean. Harduincalte it
Feverole in French. Rhases says that Fasils are flatulent, and fiuten the
body. Pliny remarks that they are eaten with their husks* He idludes^ I
suppose, to the variety of them called Dolichi. Galen says that they are
more laxative and nutritious, but not so flatulent as Pease. Oribasins says
that they hold an intermediate place between those substances which give
much and those which afford little nourishment. Tares, as Cralen and Ori-
basius mention, were sometimes used for food during a famine.
Galen, likewise, makes mention of the Lathyrus and Aracus, two varieties
of the Chichling Vetch. He says they resemble in properties the Fasils.
In an ancient Proverb, preserved by Athenaus, it is said that "Figs are to
be eaten after fish, and Pulse after flesh."
COMMBNTART ON THE FIRST BOOK. 103
LXXX. ON THE FRUCTUS HORAI, OR SUMMER FRUITS.
Galen explains that the Fructus Honei are those fruits which grow up
ahoQt the middle of the Dog-days. He says that they all contain unwhol^
some jaices, which, if they spoil in the belly, are apt to become deleterious
poisons. Mnesitheus says that all these fruits supply little nourishment, but
that what they ^ive is of a humid nature, and does not disagree with the body.
Athenseus, l5etp, lib. i'i. Dr. Cullen describes them by the name of Acido'
dulcts Frficitu, Modem authorities agree with the ancient, that they are cool-
ing but indigestible.
The Gourd {koKokvvBtj), according to Galen, is the most innocent of this
class of limits ; and yet, when it spoils in the stomach, it engenders bad
juices. Diphilus, as quoted by Athenseus, says of it that it supplies little
nourishment, is apt to spoil, dilutes the system, is readily discharged, con-
tains good juices, and is more savoury when taken with water and vinegar,
but more wholesome when pickled. Apicius gives many receipts for cook-
ing Gourds. By one of these we are directed to eat them boiled, with pickle,
oil, and wine. Most of the other receipts contain a liberal allowance of
spioes and aromatics. Simeon Seth calls them digestible and wholesome,
but not nutritious.
The Pompion (ir«r»v), according to Galen, is juicy, detergent, diuretic,
and laxative. Seth recommends persons of a pituitous habit of body to drink
old wine with it, but such as are bilious to eat acid food. He remarks that
it is apt to excite nausea. Actuarius says that, when digested, Pompions form
a thin watery blood. Apicius directs to eat them and melons with pepper,
penny-royal, honey, or raisin wine, pickle, and vinegar ; to which assafietida
may be shaded. Hippocrates calls them laxative and diuretic, but flatulent.
Galen says of the Melopepon, or Squash, that its juices are not so unwhole-
some, nor so diuretic, nor so laxative, as those of the Pompion. He adds
that, although far from delicious, it is not so nauseous as the Pompion. On
the Melopepon, see Harduins's note on Pliny, H. N, xviii. 5. Perhaps some
of the authorities may have meant the Melon by the Melopepon. Ludovicus
Nonnius mentions that the Melopepones were a superior species of the
Pepones.
Galen says that some persons, from idiosyncrasy, readily digest the cucum-
ber ((rf«n;of) ; but he insists that it is impossible that good blood can be formed
from it, and therefore he warns against the frequent use of all such fruits.
Actuarius says that it forms a crude chyme, and is of a cold, humid, and in*
digsstible nature. Celsus says that its nutritive powers are feeble. Avicenna
says that its juices are bad, and prone to putrefaction.
Melcms are said by Averrhoes to be of a cold nature, juicy, detergent, and
diuretic.
Owing to the lax signification in which the word Cucumis is often taken by
the Roman, and o-iicuo^ by the Greek writers, I have felt considerable difficulty
in distinguishing the articles treated of in this chapter. I have been obliged for
once to abandon the guidance of Sprengel, but have done so with the greatest
hesitation, and not until I had compared the descriptions of all the Greek,
Latin, and Ajabian authorities. Schneider points out the confusion about the
use of these terms, but does not sufficiently clear it up. Index to Theophras-
ftts. Ludovicus Nonnius may likewise be consulted with advantage. He
supposes that the Pepones of the ancients were our Melons; and, as we have
slated above, he is also inclined to believe that the Melopepon was a species of
the same. De Re Cibaria, lib. i. c.l6. For want of a oetter term, 1 have
ventured to translate it the Squash, although I am uncertain whether the Greeks
^ere acquainted with this fruit, now so common in the East and in America.
104 COMMUNTARY ON THE FIRST fiOOK<
LXXXI. — ON THE FRUIT OP TREES.
It may be proper, in the first place, to discuss briefly the question re-
specting the proper time for eating fruit. Galen, Rhases, and Simeon Seth,
direct to eat fruit at the beginning of a regular meal. It appears, however,
to have been customary with the ancients, as it is in Britain at the present
day, to eat all manner of fruits at the mensa secunda, or Dessert, as we leara
fr(mi Athenxus and Macrobius. Horace was fond of concluding his banquets
with fruit. He speaks of finishing a frugal repast with hung grapes, nuts,-
and figs. Sat. ii. 2; and in another place he says —
" llle salubres
iEstates peraget, qtii nigris prandia moris
Fmiet ante gravem quae legerit arbore solem.'* — Sai, ii. 4.
1 may mention, by the way, that Galen, on the other hand, positively forbids
to eat mulberries after other food. But what Celsus says i-especting tlie
proper time for eating fruit is very much to the purpose : — " Secunda
mensa bono stomacho nihil nocet, in imbecillo coascescit. Si quis itaque
hocparuni valet, palmulas pomaque et similia primo cibo assumit." Lib. i. 2.
Modern authorities are as much divided in opinion upon this point as tlie an-
cient were. Dr. Cullen maintained that the proper time for eating fruit is at
the conclusion of Dinner. Mr. Abernethy, on the other hand, when laying
down directions about the Diet of Dyspeptics, recommends to take fruit ra-
ther before than after dinner. Van Swieten, in like manner, when treating
of the Fructus Hora^ i, forbids to eat them after dinner. Dr. Paris inclines to
the same opinion. He says that ** the proper seasons for taking fruit are the
morning and evening. On some occasions it may be taken with advantage
at breakfast, or three hours before dinner ; and it affords a light and agreeable
repast if taken an hour before bed-time.*' My own sentiments on this sub-
ject accord pretty nearly with the opinion of Celsus. I would say thai much
fruit ought not to be taken at the conclusion of dinner, especially by persons
having weak stomachs, but that the practice of eating a small quantity at the
Dessert does no harm in general. Ludovicus Nonnius recommends to eat
the summer fruits, and Cherries, Strawberries, Plums, Peaches, and the like,
at the beginning ; but Apples, Pears, Nuts, Chesnuts, and the like, at the'
conclusion of a meal, that is to say, at the Dessert.
Tlie Fig was a great favourite with the ancients. Galen states that it is
decidedly nutritious, but that the flesh formed from it is not firm and com-
pact like that from pork and bread, but soft and spongy like that from Beans.
Ue says that Figs increase the urinary and alvine discharges. Averrboes says
that they are of a hot and humid temperament, and that they loosen the belly
and strengthen the stomach. See, m particular, Athenseus, Deip. lib. iii.
Macrobius, Satur. iii. 20. and Haly Abbas. Haly says that the Fig is the
most digestible, nutritious, and wholesome fruit of this class. Galen speaks
doubtfully of dried Figs.
My limits will scarcely admit of my touching upon the culture of the Grape
and its properties, as a medicine and article of food. Pliny devotes a whole
book to the consideration of the Grape and its productions. Galen says
that, like Figs, Grapes are nutritious, but that the flesh formed from them is
deficient in firmness and durability. He remarks that their stones pass
through the bowels wholly unchanged. Simeon Seth states that the Grape
<onsists of four different substances, namely, the membrane which surrounds
it, the fleshy part, the juice, and the stones. Of these, he says, the outer coat
and the stones ought lobe rejected, because they are indigestible. Plutarch
and Macrobius exert their ingenuity to explain how it happens that must, or
COMMENTART ON TUB F1E8T BOOK.
105
the fresh juice of the Grape, does not intoxicate like wine. *'Tlie Pensilis
uva," or hung Grape, is mentioned by Horace as an article of the Dessert.
Lib. ii. Sat. 2.
Galen gives Mulberries the same character as our author does. Aetius
^ys that the proper occasion for them is when the stomach is hot and dry»
According to Athensus, the Siphnian Diphilus said that they possess mode-
rately wholesome juices, and that they afford little nourisliment, but are sa-
voury, and of easy evacuation. Haly Abbas recommends them cooled in
snow for heat of the stomach.
According to Pliny, Cherries were first imported to Italy from Pontus, by
the famous Luculius. This story, however, is not very probable, as they had
been described more than a century before by Theophrastus. Athenseus
mentions further that they bad been noticed, long before LucuUus, by the
Siphnian Diphilus. Simeon Seth says that they are of a cold and humid
nature, and open the bowels. They are useful, he adds, when the stomach
and constitution are hot and dry.
Galen states that the fruit of the Pine contains thick and wholesome juices,
but that tliey are not easily digested. The Siphnian Diphilus, as quoted by
Atbenseus, says that the Strobili are very nutritious, smooth asperities of the
Trachea, and purge the breast. MnesiUieus, as quoted by the same author,
says that they fatten the body, and do not impair the digestion. Deipn. lib.
ii. Celsus holds them to be stomachic.
Our author's remarks on the Persica are taken from Galen. Seth calls
them Rhodacina. He says that they are cooling, diluent, and laxative, but
difficult to digest. If not the same as the modem Peach (which the com-
mentators suspect), the Persica was evidently a fruit nearly allied to it.
It is highly probable, but not quite certain, that the Prsecocia, Duracina,
and Armeniaca were varieties of the Apricot. Galen does not use the
second of these terms, and mentions, that many held the first and the last to
be exactly the same fruit ; and he, himself, in another place, forgets the dis-
tinction which be had endeavoured to establish between them. Simeon Seth
describes them by the name of fitpiKOKKo, which appears to be a corruption of
the Latin Praecocia. — (See Geopon. x. 73, and the note of Needham — Har-
doin's note on Pliny — Ludovicus Nonnius, u. s, and Sprengel, Dio$cor. i. 165.)
Seth says that they are firuits which soon spoil, and form bad blood.
Idala was used by the ancients as a generic term, comprehending many
species of firuit. See an interesting account of them in Pliny, xxiii. 5. Ma-
crobius, Saturn, iii. 19. and Athensus, Deipn. lib. iii. Diphilus thus
states their general characters as articles of food : ** Green and unripe
Apples are unwholesome and unsavoury, swim in the stomach, form bile,
and occasion diseases. Of the ripe, such as are sweet are more wholesome
and more laxative from having no astringency : the acid are more unwhole-
some and constipating, but such as have also a certain degree of sweetness,
become more delicious, and are at the s^me time stomachic from having
some astringency/' The ancients appear to have been well acquainted with
ihe methods of making Cider, Perry, and the like. See Macrobius, Sat, vii.
6. and Plin. H, N, xiv. 19. The Arabian authors in general speak rather
unfavourably of Apples.
The Cydonia or Quinces were in great repute, not only as articles of food,
but as medicines. When unripe they are very astringent and contain much
acid, and hence they were used in such cases as those in which the mineral
acids are now generally administered. Plinius, H, N. xxxiii. 6. They ap-
pear to be the *^ cana maW of Virgil. Columella and Pliny describe three
species, namely the Chrysoroala, Struthea, and Mustea.
iPears, according to Simeon Seth, are of a cold and desiccative nature.
They are compounded, he says, of astringency, sweetness, and sometimes of
106 COMMENTART ON THE FIRST BOOK.
acidity; and some have a moderate degree of heating and desiccaiive pro-
perties. Averrhoes gives exactly the same account of them. Of Pomegra-
nates, he says, that some are sweet and some are acid : that all of them
moisten, but that the sweet are of a more hot and humid nature. Homer
enumerates Pomegranates among the fruits which were suspended over the
head of Tantalus to tempt his appetite. Dioscoddes says, that the sweet
Pomegranates are stomactiic; but are prejudicial when there is fever.
Galen, who gives Medlars and Services much the same characters as our
author, recommends to take them only in very small quantities. Aetius and
Seth say that ripe Medlars are somewhat heating, but that the unripe are
cold, astringent, and constipating. Actuarius calls them excellent astringent
medicines, but bad articles of food. Dioscorides describes two species of
Medlars, the Aronia, and Setanium. The first species is called AzaroUo by
the Italians; the oAer is the common species of Medlar.
See an interesting account of Dates, or the fruit of the Palm-tree, in the
Hierobotanicon of Olaus Celsius. The Date, according to Galen, is a frait
possessing a variety of characters, but having always a certain degree of
sweetness and astringency. He says, it is indigestible and apt to occasion
headachs. Simeon Seth says that Dates form an impure blooa ; and Rufius,
as quoted by him, affirms that they prove injurious to the bladder. Serapion,
Rhases, and Mesne agree that tibe Date is a cold astringent fruit. Hero-
dotus, Xenophon, and Athensus make mention of a wine prepared from
Dates. Erotian s^s, that a species of bread is made from Dates, flour, and
water. Lexicon Hippocratis.
The Olive, as Pliny remarks, consists of four parts, the kernel, the oil, the
flesh, and the lees. The Drupse, mentioned by our author, were the Olives
quite ripe and ready to fidl from the tree. The Colymbades and Halmades
were Olives pickled with salt, &c. See Harduin, ap, Plin, H, N. xv. 3.
The Siphnian Diphilus, as quoted by Atheneeus, says of them that they
supply little nourishment, occasion headachs ; that the black injure the sto-
macn, and bring on heaviness of the head ; and that the pickled prove more
stomachic and astringent of the belly. Galen mentions, that Olives were
often eaten with bread before dinner in order to open the belly. Simeon
Seth says that ripe Olives are moderately hot, but tnat the unripe are cold^
desiccative, and astringent. Serapion, in like manner, says that unripe
Olives are astringent. Plutarch mentions a pickled Olive as a whetter of
the appetite. Synop. lib. vi.
The Siphnian Diphilus, as quoted by Athenseus, states, that Walnuts oc-
casion headach, and swim on the stomach ; but such as are tender and white
contain better juices, and are more wholesome ; and that such as have been
toasted in a furnace aflbrd little nourishment. Deipn. lib. ii. It appears
from Macrobius, whose account of them is very interesting, that they were
eaten at the dessert. He states decidedly that, the Rojral Nut of the Greeks
was the Juglans or Walnut. Sat, iii. 18. Simeon Seth says that, when taken
before other food, they are apt to prove laxative or emetic. Averrhoes says
the like of them. He adds, that Filberts are not so apt to produce this
efiect. According to Rhases, they are apt to prove injurious to the stomach
and liver.
The Siphnian Diphilus says, that Almonds are attenuant, diuretic, purga-
tive, and afibrd little nourishment ; that the green contain bad juices, and
are possessed of stronger medicinal properties ; but that the drieo are more
flatulent, and apter to swim on the stomach. He adds, that such as are
tender, flill, and are whitened, contain milky juices which are more whole-
some. Simeon Seth says, that bitter Almonds are hotter, more attenuant,
and more incisive than the ripe. He adds, that Filberts are the most nutri-
tious of the puts but difficult to digest.
COMMXNTART ON TUX FIRST BOOK. 107
The Pistachio nut is very celebrated in ihe East and in Sicily. See Ol.
Celsii. Hierobotanicony and Brydone*s Tour through Sicily. Galen says,
that it possesses a certain degree of bitterness and astringency, and that it
proves useful in obstructions of the liver, but that it affords little nourish-
ment. He adds, that it is neither beneficial nor injurious to the stomach.
Simeon Setli remarks, that the modems looked upon Pistacs as stomachic.
Averrhoet speaks highly of them. Rhases says they are of a hotter na-
ture than Almonds. Theophrastus describes the Pistachio tree as a species
of Turpentine, and it is now acknowledged as such.
Galen states that the best Damescenes are such as are large, spongy, and
astringent. He adds, that taken with sweet wine they tend to open the
bowels. Oribasius says that they afford little nourishment, but may be
useful for moistening and cooling the stomach. Martial calls them laxative.
It appears certain from Isidorus, that the Coccimela and Myz» were the
same as the Pruna or Plums.
Galen says of Jujubes, that they suit best with the intemperaments of
women and children. Haly Abbas states that they are cold and humid, of
slow digestion^ and apt to form phlegm.
Abu'l-fedli, as quoted by Glaus Celsius, says, of the Siliquie or Carobs,
that they are sweet astringent fruit Horace speaks of them as being an inie*
nor kind of fruit. *' Vivit siliquis et pane secundo,'' Ep. ii. 1 . And so,
also^ Juvenal, Sat. xi. 59. and Persius, iii. 55. Galen says of them, that
they are woody and consequently indigestible. Aetius says, that they are of
a dry and very desiccative nature, but possess some sweetness. Pliny men-
tions that a sort of wine was prepared from Carobs.
Ckilen says that the SycanK>res hold an intermediate place between Mul-
berries and Figs. He says, further, that they are sweetish, and of a diluent
and cooling nature. Dioscorides and Serapion speak unfavourably of them
as hemg articles ofiood which are only used in times of famine.
The Citron^ or *' Felix Malum" of Virgil, was greatly esteemed by the an-
cients. Galen calls it fragrant, aromatic, and pleasant to the taste as well as
the smell. From Theophrastus downwards, it is much celebrated as an anti-
dote to poisons. See some curious information respecting it in Athomus,
De^jm* lib. iii. and Macrobius, Sat. iii. 19. Simeon Seth says, that if
taken in moderation it is beneficial to the stomach, but that in large quantity
it proves indigestible. Serapion recommends after eating Citrons to take of
anise, mastich, and wine.
Gaden says, in general, of the wild kinds of fruit, that they supply little
nourishment, and that they are injurious to the stomach. The Acorns, ht
says further, are the best of this class, being no less nutritious than the Ce-
lealia ; lie adds, that in ancient times men lived upon Acorns ; and
that the Arcadians continued this practice, after the Cerealia were used in all
the other parts of Greece. Simeon Seth says that, although nutritious, they
aie difficiut to digest and form crude humours : and hence he recommends to
abstain from them.
Galen's opinion of Chesnuts agrees with the account given by our author
of them. Simeon Seth says, that they are very nutritious, but are hard to
digest and evacuate from the body ; and that they are flatulent and astrin-
gent Haly Abbas describes them as a proper article of food. At the pre-
sent day, whole nations of mankind live upon Chesnuts. The opinion of
Mnisitheus regarding them, as quoted by Athenaeus, appears to be very judi-
cious; he says, they are difficult to digest and flatulent, but sufficiently
nutritious if digested.
The Strawberries, or Fraga, are mentioned by Virgil, ( Eel. iii.) and Ovid.
(Metam. i.) but they are wholly unnoticed by the Greek writers.
108 COMMENTARY ON THE FIRST BOOK.
LXXXII. ON ANIMALS, AND« FIRST, OF FOWLS.
Hippocrates states, that Fowls in general are drier than quadrupeds.
The driest, he adds, are, first, the Wood-pigeon, then the common Pigeon,
and, thirdly, the Partridge, Cock, and Turtle. The most humid or juicy, he
says, are Geese. Those which live on seeds are drier than the others. The
flesh of Ducks, and of all Fowls which live in marshes, or in water, is of a
more humid nature. De DiatUy ii. 17. In another place, he calls the flesh
or Fowls one of the lightest kinds of food. De Affectianibus, c. 46.
Their general characters are thus stated by Celsus : ** £x iis avibus, quie
in media specie sunt, valentiores eee, quse pedibus, quam qus volatu magis
nituntur : et ex iis, quse volatu fidunt, firmiores qus grandiores aves, quam
quae minutse sunt ; ut ficedula et turdus. Atque e% quoque qus in aqua degunt
leviorem cibum prsstant, quam qus natandi scientiam'non habent.'' The cha-
racter here given of Water Fowls has drawn upon the author the animadversions
of Dr. Cullen. But rather than suspect Celsus of such a mistake, I am inclined
to believe that the text must be corrupt, and that we ought to read graviorem
instead of leviorem. I am confirmed in this conjecture from all the other au-
thorities, as for example, Hippocrates, Galen, Aetius, Rhases, and Ualy
Abbas, having stated that the flesh of Water Fowls is more ezcrementitious
than that of Land Fowls. If this be reckoned too bold an alteration, might
we not substitute leniorem ?
Our author takes his account of Fowls from Galen, or perhaps direct from
Oribasius. Actuarius states, that Fowls are much lighter, but not so nutri-
tious as quadrupeds ; that they are drier, more fibrous, and form thinner
blood ; and that Water Fowls are the more juicy and fleshy.
Having thus stated the general characters of Fowls as articles of iood, we
shall now briefly notice a few of those which were in most esteem with the
tons vivans of antiquity.
The Partridge was accounted a rare delicacy at the tables of luxurious
Romans. See Martial, Xenia^ Ixi. Simeon Seth says that it is easily digested,
hxki ought not to be eaten the day it is killed. According to Rhases, it con-
tains thick juices, is astringent, but very nutritious. Apicius directs to dress
it with pepper, lovage, mint, the seed of rue, pickle, wine, and oil.
Galen ranks the Pigeon next to the Partridge in excellence. The Arabians^
however, and, in imitation of them, Simeon Seth, call the flesh of the Pigeon
heating and excrementitious.
The Attagen lonicus has been celebrated by the muses of Horace and
Martial. Porphyrion, one of the ancient commentators on Horace, calls it
'* avis Asiatica inter nobilissimas habita.^ Harduin, who is deservedly
reckoned a high authority in these matters, supposes it to have been the
Gelinotte du hois, or Wood-hen, Atheneus quotes Aristophanes as calling
it a most delicious bird. Galen, Aetius, and Oribasius speak of it in the
same terms as Paulus. Apicius directs to dress it like the Partridge.
Persius speaks of the Thrush as being a much-esteemed delicacy. Sat, vi.
Horace also says, that there is nothing better than a fat Thrush. Kpi$U i. 1 5.
See Aristoph. Nubes, Athensus, Deipn, lib. ii. It is worthy of remark^
that, although the Thrush be by no means a delicate morsel in the North
of Europe, it is very delicious in Italy and Spain. It feeds on juniper ber^
ries, grapes, and the like. The Receipts of Apicius for dressing Thrushes,
and other small birds, contain spices, aromatics, honey, wine, pickle, and
oil. Averrhoes says that their flesh is drier, more aromatic, but gi-osser than
that of Pigeons. The Romans bestowed great pains upon feeding Thrushes,
as we can learn from \^arro and Columella. They also ate Blackbirds and
Larks.
COMMENTARY ON THE FIRST BOOK. 109
Martial intimates that, wlien he could get a fat Turtle to dine upon, he was
indifferent about other delicacies. According to Averrlioes, it is of a hot
nature, and has a wonderful effect in sharpening the understanding. Apicius
directs to dress it like the Partridge. Galen states, that the Turtle, Partridge,
and all fowls which are of a dry nature, should be suspended for a day before
they are eaten.
Galen mentions that the flesh of Pheasants resembles that of domestic hens,
but is more nutritious and savoury. Simeon Seth says that it is wholesome,
easily digested, and forms good blood. The Tetrao, which is mentioned by
Pliny and Athensus, is generally supposed to be the Bustard ; but Bellonius
and Ladovicus Nonnius take it for the Fasiano net^ro of the Italians, or tlie
Wood Pheasant.
Galen and oar author have omitted to take notice of Quails. Simeon Seth
says, that their flesh is heating, coarse, indigestible, and unwholesome.
RbaseSy however, says of the Quail, that in lightness it is second only to
the Starling; that it is not very excrementitious, nor accounted very heating.
Averrfaoes says, that it is of a moderate temperament, but somewhat heating;
that it is delicate, forms good chyme, and is excellent food for persons in good
health and for convalescents. Lucretius and Galen mention that the Quail
can live upon Hellebore.
Q. Ilortensius is ^ damned to everlasting fame*' for having first presented
the Peacock at his table. Varro, de AgricuU, lib. iii. Macrobius, Saiur.
iii. 13. Plinius, H, N. x. 20. iElianus, U. A. v. 25. Tertullianus, de Pallio.
It came afterwajrds to be thought an exquisite delicacy, although Horace had
declared of it that, were it not for its price, it would not be thought superior
to the common domestic fowl. Sat. ii. 2. Simeon Seth, like Galen and our
author, says that its flesh is indigestible and excrementitious. Apicius di-
rects to dress it like the Thrush. The poet, Juvenal, asserts that sudden
deaths are occasioned by the indigestion arising from eating Peacocks. Sat, 1.
The Ostrich is often mentioned by the ancient authors as an article of food,
although, as Galen says, it be excrementitious and indigestible. The ^ Afra
avis," mentioned by llorace, is said by his commentator, Acron, to have been
the Ostrich. Porphyrion, however, rather supposes it to be the Gallina Nu-
medica, or Guinea Hen, Apicius directs to dress it with pepper, lovage,
thyme or savoury, honey, mustard, vinegar, pickle, and oil. Khases says
that its flesh is very coarse.
Schneider makes the Otis to be the Tarda, or Bustard. Xenophon, who
^ves a most graphic description of the mode of hunting it in Persia, says
that its flesh is most delicious. Galen and Simeon Seth say that its flesh is
intermediate between the Goose and the Crane. Apicius gives very compli-
cated receipts for dressing it.
The flesh of the domestic fowls, says Simeon Seth, is of easy digestion,
^od contains good juices, especially the flesh of those which are beginning to
lay eggs. Chickens, he adds, are of easy digestion, and form blood of mo-
derate consistence, neither very thin nor too thick : they are excellent fqod
for persons who do not take strong exercise. It appears, from Martial, that
the Homans were fond of Capons. Lib. xiii.
The Gailinago minor is held by Ludovicus Nonnius to be the Snipe. The
Callinago major, or 2Ko\wir<i^ of Aristotle, he supposes to be the Beccasa or
^Vood•cock. It is well described in a fragment of the poet Nemesianus.
The Ficedula, called avicakis by Aristotle, was much sought afler by the
B^maos. Ludovicus Nonnius supposes it to be the Beccafigo of the modem
Italians, who are still very fond of it. Its flesh being lat, it was dressed
with much pepper, as we learn from Martial and Petronius Arbiter.
Galen and Simeon Seth agree that the flesh of Geese is indigestible and
^icrementttious, ^nd therefore nearly allied to the Ostrich.
110 COMMKNTART ON THB FIRST BOOK.
According to Martial, the breast and neck are the only parts of tiie Duck
which are fit to be eaten.
Athenaeus mentions that the Swan was sometimes brought to the table. —
Deipnos, lib. ix. Its flesh is very hard.
LXXXIII. — ON BOGS.
Our author, Ohbasius, and Aetius, copy their account of Eggs from
Galen.
Hippocrates says that they are nutritious, strengthening, and flatulent. —
See also Celsus, ii. 18.
See a curious account of the medicinal properties of Eggs in Plinii H.
N, xxix. 3.
Rhases recommends to eat Eggs in a soft state with pepper and marjoram.
Cont. xxxiii. He says that the best Eggs are those of the hen and partridge,
and next to them those of the duck. Those of geese, he says, should not be
eaten. Ad, Maruor. iii. 13.
The ancients preserved their eggs in the flour of beans, chaff, or bran. —
Plinius, H, N,x, 61. Columella, viii. 6. Varro, de Re Biutkoy iii. 9.
Pliny mentions that, if an Egg be macerated in vinegar, it will become so
soft Uiat it may be drawn through a ring without breaking. Harduin says,
that he had verified the truth of this &ict by experiment.
Horace affirms that Eggs of an oblong shape are the best :
** Longa <]pibus fades ovis erit, ilia memento
Ut succi melioris et ut magis alma rotundis
Ponere." Sat. lib. ii. 4.
I have here adopted the emendation of Dr. Bentley. The commentator,
Acron, however, read alba, but took it in the same sense as alma.
The ancients used to begin their banquets with Eggs, and hence the ex-
pression '' ab ovo ad malum,'' that is to say, from beginning to end of a
Danquet.
Galen and Simeon Seth agree that Eggs which are boiled hard, or which
have been roasted in ashes until thev are hard, become indigestible, and
supply heavy nourishment to the body ; but such as have been fried they
more especially condemn. When boiled to such a consistence as that the
white was just beginning to coagulate, they were called Tremula. When
so soft that the albumen was not at all coagulated, they were called Sorbilia.
In both these states, they are much approved of by Galen, Seth, and all the
authorities.
LXXXIV. — ON BBASTS.
Athemjeus remarks that the flesh of beasts, especially Oxen, fonned the
principal part of men's food in the heroic ages, as appears from Hom«r.
rrom one passage in the Iliad, (lib. xxiv. 1. 263.) and another in the Odyssey,
(lib. ix. 220.) it may be reasonably conjectured that they also lived upon
bmbs and kids, Deipn. i. 19. I may add, that Sophocles represents Phi-
loctetes as living, while in Lemnus, upon the birds which he killed with his
fatal bow. It is generally supposed that Pythagoras interdicted his disciples
entirely from the flesh of animals; but the truth of the matter seems to be,
that he recommended a spare use of it, and allowed to eat such animab only
as were used for sacrifices. See lamblichus and Porphyrins, de Vita Fy^
thagora. Plutarch, in two treatises, discusses the propriety of eating fleah.
COMMBNTART ON TUB FIRST BOOK. HI
Hippocrates states the particular characters of the diflere ut kinds of flesh
very correctly. He remarks^ that the flesh of wild animals is lighter than
that of domesticated.
The general remarks of Celsus may best be given in his own words : —
" Quadrupes omne animal, si lactens est, minus alimenti prsstat. Omne
etiam ferum animal domestico levius ; et quodcunque humido coelo, quam
quod sicco natum est. Delude eadem omnia pinguia, quam macra ; recentia
quam salsa ; nova quam vetusta, plus alimenti habent. Turn res eadem
magis alit jurulenta, quam assa; magis assa, quam elixa.''
Galen remarks, that the fleshy parts of quadrupeds form the best blood.
When boiled, he says, it supplies the body with more juicy, and when
roasted, with drier food. The temperament of domesticated animals, he
adds, is more humid or juicy than that of wild, owing to the dampness of
the atmosphere in which they live, and their inactivity. For, wild animals
among the mountains, being exposed to privations and fatigue, their flesh is
drier, contains no ia^ and is less disposed to putre&ction than the flesh of
domesticated animals. He states, that of all animals, whether fowls or beasts,
the flesh of such as are growing is better than those which are past their ut-
most gprowth ; that such as are at their growth hold an intermediate charac-
ter; but that the flesh of such as are very young or old is bad, because, in the
latter case, it is hard, dry, and fibrous, whence it is difficult to digest, and
not nutritious ; while, on the other hand, the bodies of very young animals,
being mucous (gelatinous?) watery, and therefore excrementitious, readily
pass through the bowels undigested.
Actuarius states, that animals which lead an indolent life are more humid
and excrementitious; whereas such as are much exercised are drier and
lighter. Upon the whole, he adds, the more the colour of flesh declines firom
white, the farther is it removed from wholesomeness. It is also to be known,
that wild animals are hotter and drier than domesticated.
Haly Abbas says, that the flesh of all animals is heating and humid, forms
much blood, and is nutritious. Avicenna remarks, that flesh strengthens the
body, and is readily converted into blood. According to Rhases, flesh is
the most nutritious of all aliments, and disposes most to plethora; hence,
those who live much upon it, require frequent venesection, especially if at
the same time given to drinking wine.
It may now be interesting to compare the opinion of Dr. Cullen with those
of the ancients on this subject. He lays it down as an ascertained rule,
Aat quadrupeds give, in the same proportion taken, more nourishment than
any vegetable aliments whatever. The latter, he says, are not like the former,
entirely convertible in tuccum et sanguinem. At the same time, he thinks
that animal food is less perspirable.
Of all idnds of animal food, Pork was almost universally esteemed by the an-
eieats as the best. Hippocrates repeatedly speaks of it as being most wholesome
and nutritious, and Galen says the same of it in the strongest language. He
states that the athletae, if for one day presented with the same bulk of any
other article of food, immediately experienced a diminution of strength ; and
if the change of diet was persisted in for several successive days, that they
fell off in flesh. He adds, that he had been credibly informed by persons
^0 had been compelled, under extraordinary circumstances, to taste human
flesh, that pork bears a near resemblance to it. Celsus praises it for its
lightness : '' Inter domesticas vero quadrupedes, levissima suilla est." Aetius,
Oribasius, and, in a word, all the Greek authorities subsequent to Gralen,
deliver exactly the same character of it as he. See, in particular, Simeon
Sedi. He says, that the flesh of swine a year old is the best, and that very
yoongpigs are not to be eaten, as being too humid and excrementitious. He
adds, tnat the flesh of wild boars furnish the best food, being neither so ex-
112 COMMENTARY ON THE FIRST BOOK.
crementitious nor so viscid as that of tame swine. The Arabian authors,
liowever, display some oriental prejudices against the flesh of swine. Avi-
cenna merely remarks of it that the Christians, and those who imitate them,
say that the flesh of the wild boar is the best of all. Averrhoes refers to the
opinion of Avicenna. Rhases, who has treated of Dietetics in three distinct
works, has nowhere, so far as I can discover, recommended pork as an
article of food. Haly Abbas, however, speaks favourably of it. He, I be-
lieve, was a Christian. Various receipts for dressing pork are ^ven by
Apicius. As a sauce for the flesh of the wild boar, he recommends a compo-
sition of honey, pickle, sodden wine, and raisin wine. Cato, the censor,gives
▼ery sensible directions for the preparation of Ham. De Re Rustica. c. 162.
It will be perceived that our author states that pork is imperspirable. Sane-
torius confirms the truth of this statement. Both Cicero and Porphyry quote
the saying of Chrysippus, that a sovl or living principle was given to swine,
as a sort of salt, to preserve their flesh from putrefaction for the use of man.
Mutton was no great favourite with the ancients. Galen, Aetius, Oribasius,
and Simeon Seth, agree with our author, that it is inferior to pork, as being
more excrementitious, and containing worse juices. Averrhoes, however, ac-
cuses Galen of being prejudiced against the flesh of wethers and lambs,
which, he afiirms, are inferior only to kids in excellence. Rhases, in like
manner, ranks mutton as second only to kid. Sedi savs, that the best rout-
ton is that of a sheep a year old. Apicius gives full directions for cooking
mutton and lamb. Lib. viii. It appears that, even at the present day, mut-
ton is by no means in so much request in Italy as it is in Britain, France,
and Germany. The Americans also are less fond of it than we in Britain
are.
All the ancient authorities speak of Goats' flesh in much the same terms as
our author; namely, as being acrid, and containing unwholesome juices.
That of buck-goats is said by Galen to be particularly bad ; and, next to it,
those of rams and of bulls. Of kid, he speaks favourably, as being next in
excellence to pork ; then he ranks veal. But lamb, he says, is humid, gela-
tinous and mucous. Rhases and Averrhoes rank kid first, and then lamb.
The poet Hesiod recommends kid as a delicious article of food during the
heat of Summer. Op. et Dies^ I. 590.
The Arabians mention Uie Gazelle (Dorcas) as being nearly allied to, but
superior to the goat. Simeon Seth says, that the flesh of the Dorcas is better
than that of any other wild animal, and that it is allied to the human body.
Hippocrates calls Beef a strong, astringent, and indigestible article of food.
Celsus ranks it among the articles which are not apt to spoil in the stomach.
Oribasius says, that it is more than moderately nutritious, but imperspirable,
and forms thick blood. Like Galen and our author, he savs, that it proves
injurious to those who are subject to collections of black bile. Seth sajrs,
that it is difiicult of digestion and distribution, but when digested, sufficiently
nutritious. Rhases says, that it supplies much nourishment of a gross nature,
and forms thick blood. Averrhoes says, that the flesh'of heifers is good, not
being so viscid, cold, and dry as the flesh of oxen. The sauces recommended
by Apicius for the flesh of oxen and heifers contain various spices, and
aromatics with vinegar, pickle, and oil.
The Glis or Dormouse is mentioned as a favourite delicacy of the Romans
by Varro, Pliny, Martial, Galen, and Ammianus Marcellinus.
All the authorities agree that the flesh of the Stag or Roe is difficult to
digest. Hence Rhases forbids to eat it, except after hard exercise. Simeon
Seth adds, that, as in Summer, stags frequently eat poisonous serpents, it
may be dangerous to take of their flesh at that season. Celsus appears to
have had a more favourable opinion of venison than most of the ancient au-
tliorities, for he ranks ^' omnis venatio'' among the things which agree best
COMMINTAET ON THK f lEST BOOK. 1 IS
with the stomach. Seth lays^ that Hare is sufficiently nutritious, if properly
digested, but that it disagrees with persons of a dry temperament, and is apt
to form melancholic humours. Apicius gives many complicated receipts
for dressing Hares. Pliny remarks, that there never is any fat on Hares.
H. N. xi. 85. Hippocrates says, that their flesh is dry and astringent.
Horace freqnenthr praises the shoulder of the Hare. In our days, the loins
are preferred. The Cnniculus, or Rabbit, was greatly esteemed in Spain, bm
does not appear to have been much used by the Greeks or Romans.
From the experiments of Sir Astley Cooper, it is ascertained, that the
solnbilit^ of animal food is in the order of pork, mutton, veal, and beef. This
account is little different from the ancient ctiaracters of them.
LXXXV.— ON TBB PARTS OF ANIMALS.
Since our author has stated very distinctly the characters of the parts of ani-
mals (haying abridged the fuller account of Galen), it will serve no purpose
for me to enlarge upon evenr one of these articles ; and, therefore, I shall
be content with makinff a few cursory remarks. For further information,
see Galenas, de AUm. Factdt, and de Euchym, — Oribasius, Med, Coll. lib.
v.^Aetins, lib. ii. — Rhases, ad Mamor. iii. 11. — Ilaly Ablms, Theor. v. 22.
—Serapion, de Simnl, ex AnimaL
Galen remarks, mat, as some rendered the liver of Swine sweet, by feeding
fliem upon dried figs, so he knew sonie persons who were in the practice of
preparing the livers of Geese in like manner, by feeding them upon milk, by
which means they were rendered not only delicious, but also very nutritious,
wholesome, digestible, and not difficult to evacuate. Oribasius and Haly
Abbes 8p€»k of it in much the same terms; but Haly adds, that much
of it ought not to be eaten at once, as it is slowly digested . Athenaeus speaks
of it as a delicacy in great request at Rome. Deipn, lib. viii. The liver of
a white goose red upon fotty figs is one of the delicacies mentioned by
Horace as having been presented at the supper of Nasiedenus. Sat. lib. ii.
8. 8. — See also JuTenat, v. 114. and Persius, vi. 7. If we may believe
Martial, tbe liver, in these cases, sometimes grew to such a size, as to surpass
the bod? of the animal. Epigr^ xiii. 58. We are informed by Pliny, that
it was dispnted to whom die Culinary art was indebted for the discovery of
thu exquisite delicacy. H,N,x.2\. Dr. Kitchiner, the modem Apicius,
says of It, " Although the liver is rather too luscious for the lingual nerves of
tbe good folks of Great Britain, the livers of poultry are considered a very
high rdish by our Continental neighbours." — took's Oracle, p. 181.
Galen states, that all fat and suet are of an oily nature, and that they ought
nAier to be used as condiments than as articles of food. Serapion gives the
Biost circumstantial account of the qualities of these animal oils.
The Vulva or Womb of a Sow, was esteemed an exquisite delicacy by the
Romans. There were three kinds of it — that is to say, it was taken in three
different states of the animal. The first, called Ejectitia, was procured by
forcing the animal to part vrith its young. The second, or Porcaria, was the
womb of the animal, taken after it had littered. The third, called Sterilis,
ivas the womb of a sow that had never been with young. This last is ranked
^ C^us among those things which are useful to the stomach. — See Plut-
aichus, de Etu Camiitm. Plinius, H. N. xi. 37. Simeon Seth, however,
<ioiidem8 it as indigestible. V, Not. Bogdani,
] 14 COMMBNTART ON THB FIRST ROOK.
LXXXVI. — ON MILK.
It appears from Homer, that the milk of various animals was used for
food in the heroic ages of Greece. His commentator, Eustathius^ remarks,
that it is very nutritious, and, in proof of this, relates the case of one Phi-
linus, who used no other food or drink. — Ap. Iliad, xiii. 6.
Hippocrates, who often makes mention of milk as a medicine, and as an
article of food, states, that it sometimes occasions the formation of stones in
the bladder (de AeribuSy Loci$, et Aqui$, c. 24); and this opinion was
adopted by all the ancient authorities on medicine; but, whether tnere be any
foundation for it or not, I cannot take upon myself to determine. Certain
it is, however, that children and young persons, who live mostly upon milk,
are very subject to Calculus ; and in the country, where milk is a common
article of food, the complaint is of frequent occurrence, whereas there is sel-
dom an instance of it at sea, where the diet must necessarily be very different.
According to Galen, the thickest milk of all, and the fattest, is that of Cows ;
the most liquid and least fat, is that of the Camel ; and after it that of the
Mare, and then of the Ass ; the milk of Goats is of a middle consistenoey
and that of Sheep thicker than it. It is clear, he adds, that thick milk coa-
tains more cheese, and liquid more whey. Liquid milk, therefore, is more
laxative than thick ; and, on the contrary, thick milk is more natritious than
liquid. He mentions, that whey, either alone or with a certain mixture of
salt, may often be used as an excellent laxative medicine. He states, that, if a
Goat or any other animal eat of scammony or spurge, her milk will be ren-
dered purgative. He says, that milk is most beneficial in complaints of the
chest, but most injurious in diseases of the head and hypochoodrium. Ht,
and all the ancient authorities after him , state, that milk is apt to hurt the teeth.
Celsus calls milk a wholesome and nutritious article of food ; but says, that
it is apt to disagree with the stomach, and to prove flatulent. The learned
Varro says of milk : '* Est omnium rerum quas cibi caus& capimus liquen-
tium maxim^ alibile, et id ovillum, inde caprinum." De R. R. ii. 11.
Aristotle arranges the milk of the Camel, the Mare, and the Ass, in the
same order with respect to consistence as Galen. H. A. iv. 20. Pliny, evi-
dently having in view this passage of Aristotle, says, that the milk of Camels
is the thinnest, then that of the Mare, and that the milk of A^es is the
thickest. This is going further than he was justified by his authority. He
remarks, that the milk of Cows gives the most cheese. H, N. xi. 41.
Dioscorides calls milk nutritious, laxative, and flatulent. His account of
its properties is interesting. Lib. ii. 74.
All the Greek authorities subsequent to Galen evidently copy from him.
Seth says, that the longer milk is kept the worse it becomes. When pro-
perly digested, he adds, it moistens the body, induces soundness thefeQf,and
is useful in complaints of the chest.
According toHaly Abbas, the milk of cows is the thickest of all, and the
most nutritious ; that of camels the thinnest, and the least nutritions ; goats*
milk is intermediate between them ; the milk of sheep, intermediate betweeii
that of cows and of goats ; and the milk of asses, between that of goats and of
camels. Thtor. v. 26. Rhases enumerates them in a considerably difiereat
order ; he says that the milk of cows is the thickest, and that of asses the
thinnest ; while that of goats is intermediate. Ad Mantor. iii. 15. Averrhoes
calls the milk of asses and of goats the best. See also Serapioo, ex AnimalU
husy c. 457 ; and Avicenna, lib. ii. tr. 2. c. 434.
The following remarks of Macrobius seem to me very acute and pertinent;
and, if well founded, they ought to operate as a powerful consideration to
COMVSNTAET ON THB FIRST BOOK. 115
erery healthy mother to suckle her own offspring. ** Quamohrem noo frus-
tra creditum est, sicut valeat ad finsendas corporis et aDimi sirailitadines vis
et natura semiDis, non secus ad eandem rem lactis quoqiie iDgenia et proprie-
tates valere. Neque in hominibus id solum, sed in pecudibus quoque animad-
versum. Nam si ovium lacte h«di, aut caprarum agni forsitan alantur : constat
ferme in his lanam duriorem, in illis pilum gigni tenehorem." Saturn, v. 11.
TheOalactophagi, a Scythian nation who lived principally ujpon mare*8 milk,
are made mention of by Homer, lUad, liii. and by Stobaeus, Semio v. Eusta-
thius says that they made much use of a preparation from milk, called Ory-
gala. Ap. Iliad. U.S.
Aristotle calls Butter the fat of milk, which has concreted to the consistence
of oil. Hist. Animal. Hecatflms, in Athenaeus' Work, calls it the oil of milk.
De^noi, lib. x Dioscoridet says that it is used for condiments instead of
oil, and in confectionary instead of suet.
LXXXVII.»-ON THB DRINKING OF MILK.
This Recount of the process of administering milk is taken from Oribasius,
who^ in his turn, is indebted to Rufiiis. Avicenna, in like manner, copies
from Ruffns. There is not in any other ancient author so full a description
of the process of boiling milk. On the ancient modes of preparing milk for
various purposes, and their uses, see Oeapon. lib. xviii. and Plinius, H. N.
nviii. 38. Pliny mentions that some cure gout in the hands and feet by
imlk. This seems a vciy plausible practice ; for Dr. Cullen observes that he
never knew a person Wbo lived upon milk and vegetables who was subject
to goot. Mat. Med. Simeon Seth joins our author, or rather Ruffus, in re-
commending boiled milk in Dysentery. He likewise praises its effects in
Phthisis and dry Coughs.
. Tbil method of preparing milk for use, by putting heated stones into it, is
mentioned by Dioscorides, Pliny, and others. Serapion recommends heated
iran. See the following chapter. Gkden was aware that milk coagulates in
the Stomach before it is d^^csted. De AL Fac. in. 15.
LXXXVin. ON THB BCHI8T0N, OR MILK 8BPARATBD INTO PARTS.
Tbb method of preparing the Schiston is thus described by Pliny : — " Me-
dici speciem unam addidere lactis generibus, quod schiston appellavere. Id
fit hoe iBodo : fictili novo fervet caprinum maxime, ramisque ficulneis recen-
tflHis miscetur, additis totidem cyaUiis mulsi, quot sint hemine lactis. Cum
iurveti ne drcumfundatur, prsstat cyathus argenteus cum frigid a aquademis-
ses ita ne quid infundat: ablatum deinde igni refrigeratione dividitur et dis-
oedit serum a lacte." H. N. xxviii. 33. The same process is briefly described
bv Dioscorides, lib. ii. 77. Pliny recommends the whey thus prepared for
Ailepsy, Melancholy, Paralysis, Leprosy, Elephantiasis, and Arthritis.
This prepars^on of milk is often noticed by the ancient authors on medicine.
It evideiitly consisted of the whey of the milk, separated from the cheese by
a fedo^iar process.
The Mdca was a preparation from Milk, and is mentioned by our author
IB another place, (lib. iv. c. 27.) It appears to have been a sort of curds
aod whey, or du lait cailU of the French, prepared by pouring hot vinegar
vpoB milk. The process is minutely describea in the Geoponics, lib. xviii.
The Ozygal, or Lac Acidum, consisted of the caseous part of the milk, se-
parated from the whey by a very complicated process, which is fully described
by Columella. Lib. xii. c. 8. It is said by Galen to posssess very refrigerant
piopertics.
i2
116 COMMBNTART ON TBM FIRST ROOK.
The Aphiogala, or Spuma LactU, appears to have been Milk reduced to
a state ot foam by violent agitation.
LXXXIX. — ON CHBBSB.
Hippocrates calls cheese flatulent and indigestible. Celsus also calls it
flatulent, and ranks old cheese among the unwholesome articles of food. He
speaks &vourably, however, of soft new-made cheese. Dioscorides, in like
manner, says that new-made cheese without salt is nutritious, good for the
stomach, of easy distribution, forms flesh, and is moderately laxative. Old
cheese, he adds, is constipating. Pliny describes the kinds in most repute
wheal he lived. H. N, xi. 97. He says that salted cheese wastes the body,
but that soft is nutritious. Lib. xxviii. 34. Varro, in like manner, says that
soft and recent cheese is nourishing, and not astringent, but that the old and
dry is the contrary. De R, R, ii. 11.
Galen's account of the nature and properties of Cheese is so ample that my
limits will not admit of my doing justice to it in my brief abstract He re-
marks that milk, when it is converted into cheese, loses its watery part, and
acquires heating properties, whence it becomes more apt to excite thirst, more
inoigestible, and unwholesome. He speaks most favourably of new-made
cheese, and mentions that there was a kind much used by rich Romans, called
Vatusicus, which was peculiarly excellent. As to consistence, the best
cheese, he remarks, should be intermediate between the glutinous and the
friable, and it ought to possess no distinct quality as to taste, unless pnerhaps
a certain degree of sweetness. Aetius, Oriluisius, and Simeon Seth, evidently
adopt the views of Galen. Seth says that new cheese is laxative, and old
astringent.
The Arabians deliver the same characters of Cheese as their Grecian mas-
ters. Avicenna, Averrhoes, and Haly Abbas, speak favourably of new cheese,
as being of a cold and humid nature.
Hippocrates and Pliny mention a species of Cheese prepared by the Scy-
thians; from mares' milk, and called by them Hippace.
XC. — ON FISHBS.
Ancient authors make mention of whole nations of mankind that subsisted
entirely upon Fish. For an account of the Ichthyophagi, see Herodotus,
lib. iii.c.20. — Plinius, lib.xi. — Strabo, Geogr. lib. xv. — Diodorus Siculus,lib.
c. 15. — Ptolemaeus Geogr, lib. iv. — Arrianus, inlndicis. — Solinus, Po/yAtstor,
lib, Ixv. — Philostratus, in Vita Apolloniiy lib. iii. The description given of
them by Diodorus is the most circumstantial and interesting. He says that
the simplicity of their diet preserved them free from diseases, but that they
were short-lived. Pliuy states that Fish were used by his countrjrmen as
food from the building of the city. H. A\ xxxii. 10. Eustathius says that, in
the Heroic ages, they were seldom used but in cases of want. Ap. Iliad. ▼. 487.
Hippocrates thus details the Dietetical qualities of fish. Speaking gene-
rally, then, he says Fishes are light food, both when boiled and roasted, by
themselves or witij other things. They differ from one another as follows : —
Those which live in lakes, the fat, and river fishes, are heavier; of sea fish,
such as are found near the shore are lighter, and those which are well boiled
are lighter than such as are roasted. The stronger kind, therefore, are to be
given when our object is to recruit, but the lighter when we wish to attenuate
or reduce. De Affect, cap. 46.
Celsus ranks Fish among those things which hold an intermediate place
between articles of a strong and of a weak nature. He thus distinguishes
COMMBNTART ON ^HB FIRST BOOK. 117
thefn from one another : — ^ Levior piscis inter saxaeditu8,quam in arenii, le-
vior in aren^ quam in limo : quo fit ut ex stagno, vel lacu, vel flumine eadem
genera graviora sint: leviorque, qui in alto, quam qui in vado vixit.''
Plutarch states that Fish is much more easily digested than Flesh. Sympos.
lib. iv.
For a fully interesting, and judicious account of the qualities of Fishes as
articles of food, see Athenseus, Deipnos, lib. viii. 14. I canouly afford room
to mention his opinion of their more general properties. He says, then, upon
the authority of the Siphnian Diphilus, that of sea fishes those that live
among rocks are of easy digestion, contain good juices, are detergent, light,
and alford little nourishment; and that those which inhabit the depths of the
sea are difficult to digest, very nutritious, and of difficult assimilation.
Galen states that Fishes which live in marshes, lakes, and muddy rivers^
are the worst as articles of food, because they are little exercised in swim-
ming, and have impure food. Such fish as live in the depths of the sea, he
saysy are almost firee from fault as aliment, for they are more wholesome and
delicious than any of the others. He mentions, as the characteristics of good
fish, that they have no offensive taste or smell, have little fat, and can be kept
for a considerable time without becoming putrid, especially if put in ice. He
says that Fish are the best possible food to persons of indolent habits, old
men, and invalids, but that they do not answer so well with persons who take
strong exercise.
Of Fishes, as aliments, there is an excellent account in a Fragment of
Xenocrates, lately published, with interesting Notes, by the learned Dr.
Coray of Paris. He says that roasted fish are most nutritious, but are of dif-
ficult evacuation ; that the boiled are less nutritious, but are readily evacuated;
that sea fish are savoury, agree with the stomach, are of easy distribution,
form proper blood, impart a good colour, and clear the belly. Such as live in
rivers and lakes, he adds, are bad for the stomach, form thick juices, and are
of difficult evacuation. The characters of the different Fishes are afterwards
stated by him very fully. He says that the parts next to the tail, as being
most exercised, are most wholesome.
Oribasius's account of Fishes is mostly taken from Xenocrates. Aetius is
full and correct on this subject. He says that the best fish are those which
live in a sea of pure water, especially if it be agitated by winds, and if its
shores be sandy and not clayey.
Actuarius says, that of Fishes which live at the sea-shore, and among rocks,
the larger supply much nourishment, of a thick nature ; and the smaller, lit-
tle nourishment, of a pure nature. He says, further, that sea fish in genera),
being preferable to those which live in fresh waters, differ however from one
another in several respects ; that such as live in the open sea are more exer-
cised, and enjoy purer food, than the others, and hence their fiesh is firmer
and purer, and they are more nutritious, and form thick blood ; that such as
live in canals and marshes are bad and unwholesome ; and that those which
live among rocks in pure waters have better flesh, and, being light and di-
gestible, form thin and pure blood.
Simeon copies freely from Galen and our author. Upon the whole, he
says, the blood which Fish form is thinner than that from land animals.
Fish, he says, is the most proper food of invalids and convalescents.
Rhases states that Sea and River fishes are the best, especially such as
have rough scales, are not mucilaginous, and are naturally of a white colour.
Those, he adds, which are of a black or red colour should be abstained from.
He saya that all fish remain long in the stomach undigested. It is now ge-
nerally admitted that they are less digestible than the tender flesh of quad-
rupeds.
Avicenna delivers the general characters of Fishes in the same terms as
Galen. He says that the best are those the flesh of which is neither too hard
116 COMlfSMTART ON THS FIRST BOOK.
and dry, nor, od the other hand, too macilaginous^-^nd which are nei-
ther very large nor very small. Averrhoes repeats this accoant of then.
Ilaly Abbas, in like manner, abridges Galen. He says that fresh fish are of
a cold and humid nature, and engender phlegm.
The ancients ate their Fish either roasted, boiled, fried, or in soups. In-
valids were recommended to take them boiled. The fried were believed to
suit only with persons of a strong constitution. On the Soups, see Z«»/mk in
lib. vii.
We shall now offer a few remarks upon some of the Fishes which were in
most request at the tables of the ancients.
The Laibrax, or Lupus, is generally supposed to have been the Pike. But
Aristotle, Oppian, and Ousiodorus describe it as being a cunning iisb, which
does not accord with the character of the Pike. Bochart concludes, that it
is the fish called XuvpaiUy by the modem Greeks ; Varoloy by the Italians ;
and Bar, by the French. It was probably, then, the Barb. locsins, as
quoted by Athensus, says of it, that it contains good juices, but is not very
nutritious, nor readily evacuated, but is the most delicious of all fishes. Ar-
chestratus calls it *^ the ofispring of the gods." Lupi caught in the Tyber
were esteemed the best. See Horace, iS^^. lib. ii. s. 2, and Macrobios, Sa-
turn, iii. 16. There were two species, the Lanatus and the Varins, of which
the former was in most esteem. Ausonius says, tliat it is the only fish which
age improves.
The Rhombus was esteemed a remarkable delicacy. The classical reader
will recollect the ludicrous importance attached to the capture of one by the
flatterers of Domitian, as described in the 4th Satire of Juvenal. It is fi«-
quently made honourable mention of by Horace and Martial. According to
liarduin and Nonnius it was the Turbot. Athensus calls it sweet and nu-
tritious. Celsus ranks it among ^^ res boni succi.'' According to Atheneus,
it is the same as the ^Inftra of Aristotle. It is called '^uno¥ by Seth. V.
Not a Bogdani.
The Cephalus w:is a species of the Mullet, as is stated by Harduin, ap.
Plinii, H. N. ix. 26, Schneider, ap. ^liani. Nat. Anim, i. 12, and Lu-
dovicus Nonnius. Oppian describes the fishing of it in the most striking
manner. Galen remarks, that the flesh of it differs much in quality accofd-
ing to the nature of the place in which it is found. Athenvus ranks it among
the fishes which are sweet and nutritious. Simeon Seth and Aetius say, that
the River Mullet is bad for the stomach, indigestible, and apt to form
phlegm. It appears from Anaxilas, as quoted by Athensus, that its head
was in most repute. Archestratus says that it is best in the winter season.
The Trigla, or Mullus, as Nonnius, Harduin, Schneider, and Coray state,
was the Surmullet. It is mentioned as a rare delicacy of grant price by
Horace, Sat. ii. 2, Juvenal, Sat. iv. 15, Martial, Xenia. c. 74, and Macro-
bius, S/ttumal. iii. 16. Athensus says of it, ^ Diodes writes that the flesh
of the Mullus is hard.'' Lib. vii. 21. Its liver prepared with oil and wine is
said by Galen to have been esteemed as a peculiar delicacy.
I need not say how much the Murene was sought after by all the lovers
of good eating in ancient Rome. Pliny, Martial, and Macrobius inform us,
Uiat those from Sicily were in most esteem ; and Brydone takes notice of
the peculiar excellence of the Sicilian Murenes at the present time, or, I
should rather say, when he performed his tour through that Island. According
to Icesius, it is as nutritious as the Eel. Athen. Deip, lib. vii. Apicius gives
various receipts for the dressing of it. Pepper, wine, vinegar, and oil are ingre-
dients in almost every one of them. The Murene which was served up at
the supper of Nasiedenus had a sauce or soup formed of such things. Hora-
tius, Sat. ii. 8. It is related of Vedius Pollio, that he fed his Murenes with the
bodies of condemned slaves. Plinius, H, N, ix. 23, and TertuUian, dc
COMMBNTAKT ON THB flMT BOOK* 119
FaUio, L. CiaMuiy the oralDr, put on mouniiog clothes for the death of a
Mureoe. Macrobiosy Sat, iii. 15.
It is supposed, by most of the classical commentators, that the Acipenser
was the Sturgeon, but this is not certain. Its popularity appears to have
been great in the days of Horace, but it had fallen mto disrepute in the time
of Pliny. It seems, however, to have retrieved its character afterwards; for
one of the authorities quoted by Atheneeus, says that it was presented at the
Roman banquets, crowned with garlands, and accompanied with the playing
of pipes. See also Macrobius, Sat, iii. 16. Martial speaks of it as a much-
esteemed delicacy at the Imperial table. The Elops and the Galeus Rho-
dhis were fishes nearly allied to the Acipenser. See Pliny and Athensus.
Martial mentions the Gobius, or Gudgeon, as being the first of the Viands
presented at the banquets of the Venetians. Xenia, £p. 83. Juvenal speaks
of it as being a fish of little value, or, at least, low priced. Sat, xi. 37. It
is in feet, as Galen states, a very small fish ; but he represents it as being de-
licious, digestible, and wholesome, especially when caught on a stony or
rocky shore. Seth gives the same account of it. Diphilus, as quoted by
Athensus, says, that when its flesh is white the Gudgeon is tender, whole-
some, and digestible. The Perch, according to the same authority, bears
a close resemblance to the Gudgeon. Ausonius calls it the delicia mentO'
rum, Galen calls it a delicious fish, which is not only of easy digestion
but most wholesome. He adds, that it, and other fishes of the same descrip-
tion^ fbna blood of a middling consistence, that is to say, neither very
watery nor too thick. And here, by the way, I would notice the opinion of
Dr. Cullen, who denies that fish afibrd weaker nourishment than fiesh does.
Dr. Paris, however, agrees with the ancients, that fish do not afibrd the same
strength and stimulus to the body as the flesh of certain land animals.
The Aaguilla, or common £el, and the Congrus, or Conger-£ef, were de-
spised by the Roman gounnands, but were greatly esteemed by the Greeks.
Icesios says that £els are the best of fishes.
On the Salmon the Greek authors are entirely silent. It is briefly noticed by
Plioyy H, N, ix. 32 ; but the first and only satisfactory account of it which is
to be found in any Latin classic, is contained in the Mosella of Ausonius. As
the Salmon is the most esteemed of all fishes in the part of the country where I
leside (^ Abredonia Salmonum piscatu nobilis,'' Buchanani Hist, Scotia:\
I am induced to give an extract from the lines in which it is first correctly
described:
'* Teqne inter species gemhias, neatromque et ntrumqoe,
Qui neodom Salmo, nee jam Salar, amUgmuqae
Amborom medio Fario interoepte sub sevo.'*
Here we find marked distinctly the three progressive stages in the growth
of the fish. The Salar is evidently the Sea Trout, the Fario is what in the
with of Scotland is called the G(ifse, and the Salmo is the full-grown Sal-
mon. Of the Salmo he says :
'' Ta lorieato sqnamosus pectore, frontem
Lnbiicusy et dubue factums fercula cense,
Tempera longamm fers incorrupte morarum,
Pnesignis macnUs capitis : cui prodiga nutat
AlvQS, opimatoque fluens abdomine venter."
The Sea Trout is well described in the following line :
** Porporeisqae Salar stellatus tergora gattis.''
Ladovicus Nonnius conectly remarks that, although the head of a Salmon,
^ being the fattest part, be in most esteem with gourmands^ it is not the most
120 COMMBNTABT ON THX FIMT BCM)K«
wholesome. The whole fish, he says, is of difficult digestioD, and forms
thick chyle. He considers it to be the Aruhordgo oi Oasiodonu. De Etu
Piscium^ c. 31.
Ludovicus Nonnius confesses his inability to determine what the Scani»
was. Xenocrates praises it as being savoury and of easy digestion, but of
difficult distribution and evacuation. For a curious account of it, see Ma-
crobius, Sat. iii. 16.
The Aurata, called by Nonnius in French Brame de mer, and by AinswortH
and Artedi Gilt-head in English, is said by Celsus, and Mnesitheus as quot-
ed by Athenseus, to be a fish of difficult digestion but very nutritious. Xeno->
crates says, that its flesh is firm, white, of easy distribution, and nutritioas.
The Passer, called Platessa by Ausonius, is supposed by Artedi and Non-
nius to have been the Plaise. It is mentioned by Horace among the deH-
cacies at the sujpper of Nasiedenus. The Solea or Sole, called Lingualaca
by Festus and Varro, was nearly allied to it. Diphilus says, that both are
very savoury and nuti*itious.
The Lampetra, or Lamprey, according to Nonnius, is the Mustellaof Auso-
nius, the Exormiston of Cassiodorus, the ydka^ias of Galen, the *x^prfi9 of
Oppian, and the ^Xka of Strabo. It was reckoned unwholesome.
The Capros, or Carp, is called by Archestratus " The Flower of Nectar/"
Athen. Deipnos. lib. vii.
XCL — ON THE TESTACBA AND CBU8TACBA,
Dr. CoRAY correctly states in his Note* on the Fragment of Xenocrates^
that, in the ancient classification of Animals, the oarpeucfaSff or oarpaKobtpfiOy,
were subdivided into the o-ickrjpxHrTpaKci^ or Testacea, comprehending
Oysters, Muscles, &e. ; and the fiakoKoarpaiea, or Crustacea, compr^ending
the Crabs, Paguri, &c. But, as he remarks afterwards, the fniaipwrrpoKa
were often called by the generic term, o<rrp€ueob*pfia. The following are his
words : *^ 0<r¥paKta icaXct a Koivortpov oarpcucolitppa'KeYtTat* Taora dc dccii'*.
pfLTM €is r€ ra o-KkrfpoirrpaKa ra km r^ ytvuctj^ r&v oarpoKo^ppMV otfopan
&g cifi TO iroXv K/dkovpfvcL, Kai ra paKoKoarpcuca otoi €uriv aoTOKOiy Kapafitu^
Kopidcff, irayovpoiJ* The ancient division of the lower classes of animals is
derived from Aristotle's History of Animals, lib. iv. and with some sttgfat
modifications it is the same as the classification lately adopted by Baron
Cuvier. Pliny thus distinguishes the Mollusca, Crustacea, and Testacea :
** Piscium quidam sanguine carent, de quibus dicemus. Sunt autem tria
genera: in primis quee mollia appellantur (^3io//ttsca?J: deinde contecta
crustis tenuibus (Crustacea f) : postremo testis conclusa duris ( Testacea 1).
Mollia sunt, loligo, sepia, polypus, et cetera ejus generis,'^ &c. In another
place, however, he introduces confusion by applying the term Mollia to the
Crustacea. This mistake probably originajted in the resemblance between
the Greek terms /xoXoxta and pciKcucoa-rpaKa. H. N, lib. ix.
I may mention further, that, in Oppian's delightful Poem on Fishing, the
Crustacea are described at book i. 1. 259, the Testacea at 1. 283, and the
Mullusca at 1. 638. On the terms used by ^lian, see de Nat. Animal, ix. 6.
Ed. Schneider. Athenaus gives a long disquisition on these animals in the
third book of the Deipnosophista.
We shall now briefly notice the ancient opinions on their Dietetical qua^
lities. From Atheneus, I can only find room for the following extract:
^* Regarding the Testacea (o(rrf>ajcod€pfia) the Siphnian Diphilus writes thus:
* Of the Testacea, the Squilla, Astacus, Locusta Aquatica, Cancer, and Leo
Marinus, are of the same genus, but differ from one another : the Leo is
larger than the Astacus, the Locusta is more fjeshy than the Cancer, and the
COMMSMTAET ON tMM fIBftT BOOK. 121
Cancer, or Crab, is heavy and indigestible.' Mnesitbeus, the Athenian, in his
work on Dietetics, says, that the I^custa, Cancer, Squilla, and the like, are
all of difficult digestion, and yet they are much easier digested than other
fishes."
GraleQ*s accoont of them is interesting; but our author's is abridged from
it. In general, he remarks, those which have hard flesh are most nutritious,
but indigestible. They all contain saltish juices whidi are of a laxative na-
ture. He says of the Crustacea that they have all firm flesh, and are, there-
fore, difficult to digest, but nutritions. Aetius and Oribasius copy from him
without the slightest alteration of any consequence.
According to Dioscorides and Alexander, the Echinus is stomachic and
diuietic. j£lian, in like manner, calls it a restorative to a weak stomach.
H. N, lib. xiii.
Actuarius sajTS, that the Crustacea hold an intermediate place between the
FUhes and MoUasca; that they are, therefore, not so indigestible as the
Mollusca, and form purer and thinner blood ; that the Testacea, as they get
no exercise, are less proper; and that all form a thin and vratery blood.
I need scarcely remark, that the Romans esteemed the Cochlea, t. e, li-
macon, or White Snail, as an exquisite delicacy.
Simeon Seth's accouqt is entirely borrowed nom Galen.
The receipts of Apicius for dressing the Ixxiusta and Carabus contain
pepper, cumin, rue, mint, vinegar, wine, and oil.
It appears from Uie following lines of Juvenal, that British Oysters were
greatly esteemed by the Roman gourmands : —
** C^Tcma nata forent, an
Lucrinum ad saxnm, Rutapinove edita fdndo
Ostrea caUebat, prime dqprendere morsn.'* — Sai, iv.
Rochester is supposed to be the ancient Rutapinum. Seneca represents
tbem as wfaetters and not food. ** Ostrea non cibi, sed oblectamenta sunt,
ad edendum saturos cogentia." The Poet Matron, as quoted by Athenaeus,
calls them ** the Truffles of the sea." Athenseus says, that Oysters caught in
the sea adjacent to a lake or river are the best. Xenocrates remarks, that sea
Oysters are small and saltish.
XCII. — ON THK MOLLUBCA, OR MOLLIA.
Galen remarks, that the Mollusca, or Mollia, have no scales, nor any
rough Testaceous sdcin, but a soft one like that of men. Their flesh, he says,
is hard, indigestible, and contains a small proportion of saltish juices; but,
if digested, it aflbrds no little nourishment to the body. The Sepia, or Cut-
tle-fish, was anciently, and is at present, much used in Rome as an article of
food. Pliny states, that it is laxative. He adds, that it is taken in food,
boiled with oil, salt, and barley-meal. Simeon Seth says of it, that it is dif-
ficalt to digest, but that, if digested, it aflbrds considerable nourishment to
the body, and engenders crude humours ; on which account, it ought to be
taken with acrid condiments, and an old thin wine drunk afterwards.
Maesitheus, as quoted by Athensus, says, that the flesh of the Mollusca is
indigestible and aphrodisiacal.
Apicius directs to dress them in much the same way as recommended by
Seth, that is to say, he recommends to add to them spices, hot aromatics,
^iae, vinegar, and the like.
122 COMMJKNTAAT OV THX FIBST BOOK.
XCIII.^^ON THB CABTILAOIMOUS FIgHBB.
For an account of the ctKaxt, or Cartilaginea, see Aristoteles^ H. A.
lib. V. — Plinius, H, N, ix. 40- — Oppianus, Haiieut, lib. i. — ^^lianns, N. A.
xi. 37.
Galen says, that tiiey are called irtkax'i ^m o-cXar fX'w, because their flesh
has a shining appearance at night. He states, that they are moderately nu-
tritious. He remarks, that the parts abont the tails of such fishes are more
fleshy than the middle.
According to Athenaeuny the Cartilaginous Fishes in general are flatulent,
fleshy, of difficult digestion, and, if eaten in great quantity, blunt the sight. —
Deipnos. lib. viii.
Dr. Coray says, that the Frendi call the Punj Ange or Angelot, the Baros
Raie bouclee or Cavellade, the Atioparog Raie miralet, the f^apicrj Torpille
or Raie torpille, and the Tpuy^v Pastinaque. Harduin gives them nearly
the same French names.
XCIV.*— ON THB CBTACBA.
Galen states, that the flesh of all the Cetacea in its recent state is excre*
mentitious, but when pickled becomes more attenuate and easier converted
into blood. He gives them, in short, the same characters as our author does.
For a full account of the pickled fishes of the ancients, I refer to the Frag-
ment of Xenocrates, and the third book of Atheneeus. I shall give the general
character of them as delivered by the latter, upon the authority of the Sipb-
nian Diphilus. He says, that the pickles prepared from sea, lake, and river
fishes, aSOford little nourishment, contain few juices, are of a heating rmtaare^
are good for the belly, and whet the appetite. The old, he adds, are better
and more acrid. See also Galenus, de Alim, Facult, iii. 41.—- Hippocrates
saysy that they are desiccant, attenuant, and for the most part laxative. De
DuBta, — Diphilus says, that they are whetters and laxatives; and henee
Galen directs to take them at the commencement of a meal, and partioilarly
recommends them for old men. Rhases speaks more un&vourably of them.
It may be proper in this place to give some account of the Ist^to, or IskiOy
of the ancients. With regard to the etymology of th^ word, then, it is de*
rived by Macrobius, ab insectione. They consisted of minced meat, either
flesh or fish, boiled or roasted, and seasoned with pepper, cnmin, lovage, and
the like. Apicius gives receipts for preparing several dishes of this kind,
from the Loligo, Sepia, Locusta, and Swines Liver. The last-mentioiied
was inclosed in the omentum, or cowl, and must therefore have resembled
the dish now called a Haggis. Lampridius says, that the Emperor Hdio«
gabalus was the first who prepared Isicia from fishes. Oysters, Lobsten,
Squills, and the like. If this statement be true, the works of Apidus, which
we possess, cannot be genuine. On the Isicia^ see further Ladovicus Non-
nius, de Piscium Em, c. xxxviii. and Lambecius, op, Apk,
XCV.— ON THB FROPBRTIBS Of WINB,
The opinions of the ancients on this interesting subject may be best learned
by consulting Hippocrates, de Diatd, lib. ii. 22, et alibi — Census, lib. ii.—
Plinius, H, ff, lib. xiv. and xxxiii. 22-26 — Dioscorides, lib. v.---Giden!»,
de Sanit, Tuend, lib. v. 5. and de^Alim, Facult, lib. iii.— Oribasius, Med, Col.
lib. V. and Euporist. u 12. — ^Aetius, lib. i. — ^Athenaeus, Deipnos, lib. i. —
OOMMBlfTAET OM TBB rUMT BOOK* 128
Macrobiufl) Saiurnal, — ^Actuarius, de DktUy c. 8 — Simeon Seth^ de AUmen-
/is— Senpioiiy ib SimpHciinu^ ifc, — Haly AblNts, Tkeor, v. 30^ and Pract.
i. 8 — ^ATioenna, lib. i. fen. 3. doct. 2 — Rhases, ad Mamor, iii. 5, and Con-
tinent, lib. xxxvii. — AlsabaraTius, Theor, xiii. 2w— Stolraens gives an interest-
ing collection of the opinions of the Philosophers and Poets, Sermo xviii.
For an ample account of the ancient and modem wines, the reader is
particularly referred to the late ingenious and classicai publication of Dr.
Henderson. See also Barry on Andeni FFtnes, and Canonherius, de Admi-
randis Vini Virtutibui.
From the works of Moses and Homer, we learn, that the art of coDverting
the innocent juice of the Gfape into wine must have been a very early in-
vention. Eostathius informs us, that, in very ancient times, the wines were
all of a dark-colour ; and hence Homer applies to the Sea the epithet of
wime^oiouredijiufom worrov). Comment, in Iliad* I, However, in the time
of Hippocrates, they had wines of all colours, as well as characters. He
ihus oMcribeB their general properties. Black and austere wines are of a
drying nature, and are not laxative, nor diuretic, nor sialogogue. It is their
hax that renders them desiccative, by consuming the humidity of the body.
The soft dark vrines are of a more diluent nature, and are more flatulent and
laxative. The sweet dark wines are of a men mmstening nature, but they
are heating and flatulent by imparting humidity. The white austere wines
are heatiiig, but are rather diuretic than laxative. The new are more laxa-
tive than the old, as being a nearer approach to Uie fresh juice of the grape,
and they are nutiitious ; and the fragrant wines than those of the same age
whicb luive no bouquet, because they are better concocted ; and the thick than
the tkin. Bot thin sweet wines are more diuretic, laxative, and diluent, and
form weak blood.
Celsiis ranks the ^ vinnm dulce vel lene'' among the ^ res boni succi.'^
Sharp awMtere wine he places among the things which are most suitable for
the stomach.
Dioecorides deUvera very judiciously the different characters of wines.
He concludes with leniarking, that, although habitual intoxication be preju-
dicial to the bcahb, a moderate indulgence in wine for some days, especially
ifter drinking water, is beneficial, by proving an alterative to the sjrstem,
pargiiig the secretions, and promoting the insensible perspiration.
From Pliny's excellent detail of the Medicinal and Dietetical properties of
Wine, I select the following remarks : — ^* Vino aluntur vires, sanguis color-
^ae hominum. Vino modico nervi juvantur, copiosiore laeduntur, sic et
4)cttli. SComadius recreatur; appetentia ciborum invitatur; tristitia et cura
liebetatur; urina et algor expellitur; somnus conciliatur. Preterea vomi-
tees siatit. Vetus coposiore aqua miscetur, magisque urinam expellit;
Hiims siti resistiL Dulce minus inebriat sed stomacho innatat; austerum
4etli«is concoquitur. Stomacho minus utile est pingue, nigrum, sed corpoca
nagis alit. Tenue et austerum minus alit, magis stomachum nutrit."
The information supplied by Galen on this subject is most ample, but in
(oo diffuse a -shape to suit my narrow limits. Upon the whole, he states,
tbin wines are diuretic, but supply little nounshnient, whereas the thick
lie proportionally nutritious. He says, that the Falemian, especially the
sweeter kind, is one of the most wholesome wines. Athensus gives an in-
teresting account of the Falemian, upon the authority of Galen. He says,
it is fit to be drank af^er it is ten years old, and from fifteen to twenty ; but
that, when older, it occasions headach and affects the nerves. He describes
two kinds of it, the sweet and the austere. The latter, he adds, is off a
yellowish colour, that is to say, a colour intermediate between the white and
l>lack. Dr. Henderson concludes, that the modem Madeira is a near ad-
pioach to the ancient Falemian. Galen gives very minute directions for
124 COMMENT ART ON THE FIRST BOOK.
forcing this wine, or giving it premature age by heat. De Antid. lib. i.
Athensus says, that wine digests the food, and, being of a subtle nature, pro-
motes the distribution of it. Although wine does not promote the digestion
of food chemically, it may rouse the vital energies of the stomach to perform
its functional office.
According to Actuarius, the thick wines are most nourishing and form the
thickest blood, but are apt to occasion visceral obstructfons; while, on the
other hand, the thin wines are more stomachic and less nourishing. The
sweet are the contrary ; but the white are less hot than the others ; the gold-
coloured are more hot; and then the red.
Wine, says Simeon Seth, is not only nutritious, but promotes in a great
degree the distribution of the food over the body, rousmg, and at the same
time increasing the vital heat, and with it the urinary and other secretions.
It suits best, he says, with persons of a cold and dry temperament ; and,
therefore, it is most proper for old men. He adds, that the immoderate use
of wine dissolves the vital tone, depresses the natural heat, and occasions
apoplexy, epilepsy, and tumors of the body. Macrobius attempts to trace a
resemblance between the effects of habitual intoxication and those resulting
from exposure to extreme cold. ** Quscunque nimium algentibus, eadem
contingunt ebriis. Fiunt enim tremuli, pallidi, graves ; et saltu tumultu-
antis spiritus artus suos et membra quatiuntur. Idem corporis torpor am-
bobus, eadem linguse titubatio. Multis etiam morbus ille quem vapaKva-of
Grsci vocant sic nimio vino, ut multo algore contingit.'' Id like manner, ft
modem writer, Andreas Baccius, maintains that some wines are of a cold
nature.
Haly Abbas gives nearly the same characters of wine as Seth. His ac-
count of all the wines, natural and artificial, used in his time, is most ample.
Alsaharavius forbids to take wine when the stomach is quite empty, or
after a full meal. When taken seasonably, he says, it improves the appetite,
increases the vital heat, nourishes the body, and clears the senses.
Avicenna, with his usual judgment and industry, collects all the infinma-
tion of preceding authors, to which he adds his own opinions. He remarks,
that the immoderate use of wine induces disease of the liver and brain, ana
debilitates the nerves.
Wine, says Rhases, warms the stomach and liver, and dispels flatulence,
promotes digestion, provokes the urinary and alvine discharges, and glad-
dens the mind.
Serapion copies mostly from Galen in delivering the general characters of
wine. He disapproves of wine made with salt water. For an account of
it, see Pliny and Athenseus, u. s.
The ancients were scarcely more agreed respecting the intoxicating pro-
perties of Wine than they were as to the powers of the Cabbage in counter-
acting them. Old Cato the Censor, who was in the practice '' of warming
his virtue with wine,'' describes the following method of cooling it : — ^ Si
voles in convivio multum bibere csnareque, ante ceenam esto crudam brassi-
cam quantum voles ex aceto, et item ubi csmaveris comesto aliqua V folia,
reddent te quasi nihil ederis, biberisque, bibesque quantum voles.'' De
R. R, c. 156.— See a long dissertation on this property of the Cabbi^e in
Athensus, Deipnos, lib. i. ap, finem ; also Plinius, if. 'N, xx. 34. — Pseudo
Dioscorides, Euporist, i. 24. — Nonnus, c. 14. — Simeon Seth, in voce BragsicUy
Geopon, xii. 17. Avicenna, Rhases, and Serapion, give the same character
of it. Traces of this opinion may be found in the works of Amaldus Villa-
novanus, Canonherius, Baptista Porta, Culpepper, and other modem
writers. I have been told, that the more intelligent votaries of Bacd^us at
the present day sometimes have recourse to this simple method of pacifying
COMMBNTART ON TBS FIRST BOOK. 125
his DiTinity I — Plutarch afiBrms, that Almonds also are a presenrative from
intoxication. Quast. wi.
Before quitting this subject, I must notice certain peculiar modes of pre-
paring Wine. The Mustum was Wine newly made, or the fresh juice of the
grape. The Protropum was the juice which runs from grapes without
pressing. The Mulntm was a preparation of Wine and Honey. Dioico-
rides recommends two parts of Wine to one of Honey ; but there does not
appear to haye been any fixed proportion. The Sapa, called by the Greeks
Mq^sema and Siraum^ according to Pliny is Must, boiled to a third ; and the
DefnUum the same reduced to a half. They are now called Robs. Tha
Carenum, according to Isidorus, is Must reduced to two-thirds. The Possum
was a sweet Wine prepared from grapes which had been much dried in the
son. The Possum Creticum, which is much praised by Pliny and Atheneus,
and is often mentioned by our author, the learned Andreas Baccius and
Nonnius beliere to have much resembled the modem Malmsey. The
ancients prepared a peculiar species of Wine with salt water. — See Plinius,
jff. N. Ub. xlv.
It is scarcely necessary for me to remark, that the ancients generally drank
their Wines duuted either with hot or cold water. Hence the poet Juvenal
says : — ** Quando ^ocatus adest calida gelidaeque minister.*' According to
Puny, Staphylus first introduced this practice, K. N, viii. 56; but Atheneus
refers it to Melampus, lib. ii. It would appear, however, from some pas-
sages in the Ecctesiazusa of Aristophanes, and from Eustathius's Com-
mentary on Homer, Iliad, ix. 203, that the ancients often drank their wines
undiluted.
XCVI. ON HONBT, AND MEAD, OR HONIBD WATBR.
HoKET, says Hippocrates, when eaten with other food, is nutritious, and
improves the colour ; but, when taken alone, it rather attenuates than recruits.
Actuarius says, that scummed honey, when taken with other food, is nutri-
tious and laxative. Democritus said, that health viras best promoted by lu-
bricating the inside with honey, and the outside with oil. Honey and bread
formed the fa?ourite food of the Pythagoreans. Athensus, Deipnos, ii. 7. —
See also Oribasius, Stfnops, iv. 38 — Haly Abbas, v. 27---Simeon Seth, in
voce Mel.
Galen gives the following account of the phenomenon of a Honey^shower : —
" I have sometimes known in the season of Summer a great quantity of
honey to be found upon the leaves of trees, shrubs, and certain herbs, so that
the country people said, jesting, * Jupiter has rained Honey.' A cold night,
as for Summer, had preceded (for it happened in Summer) ; but the tem-
perature of the former day had been hot and dry. It was thought, there-
lore, by those who were skilled in Nature, that an exhalation from the earth
a&d waters, finely attenuated and concocted by the heat of the sun, had been
condensed and collected by the cold of the succeeding night. This phe-
nomenon occurs rarely with us ; but it takes place frequently in Mount
Lebanon every Summer.'' De Alim. Faadt. — See also Fragmentum Theo-
phrasti de Melle ed. Heinsius. Emestus Faber states, that die Honey here
described is the Manna of Cedars. De Manna Ebraorum, c. 12.
Our author has given one method of preparing the Hydromel, or Honied
Water. Different modes are described by other authors. Thus, Mesne re-
commends to use seven parts of water to one of honey. It appears from
Hippocrates, however, that it was taken more or less diluted. Pliny and
Bioscorides make mention of Hydromel prepared by mixing two parts of
water with one of honey. This seems to have been the strongest Hydro-
126 COMMENTAET ON THE FIEST BOOK.
mel. A species of Hydromel carefully prepared, and kept ibr a considerable
time, was esteemed a delicious beverage. Ludovicus Nonnius compares it
to the Mead used by certain nations of the North. They prepare it with
hops and yeast, so tliat it it made to emulate the nature of wine.
XOVIL— ON SLEEP.
The philosophy of sleep is ingeniously treated of by Hippocrates, de In-
iornniUy and by Aristotle in his treatise de Somno et Vtgilia, Aristotle
states, that digestion goes on best during sleep. Plinjr's definition of sleep
seems to be taken from Hippocrates : — ** Est autem Somnus nihil aliod quam
animi in medium sese recessus.'* H.N. x. 97. Alexander Aphrodissus^ in
like manner, says : — '* Know, that during the day, the natural principle is
less occupied with its own peculiar operations, I mean the digestion of the
food, the changes of the chyle, sanguification, distribution, assimilation, and
the like, the mind being engaged in its other energies, namely, the five
senses, phantasy, reasoning, and memory ; but, during nisht, on the other
lumd. Nature operates more, and the mind less.'' — FrohUm 'u 1 18. — See
also particularly Oribasius, Med. Collect, ▼i.4. — Actuarius, de Diata c. 11.-^
Aficenna, lib. i. fen. 3. doct. 3/— Rhases, ad Mansor. iv. 3.^— Haly Abbas,
Tkeor. T. 35. — Alsaharavius, Theor. xi. 3. — Averrhoes, CoUect. §- i. 21.—
Aferrhoes defines sleep to be the recession of the sensorial powers from their
organs to the internal parts; and hence, he remarks, those who sleep with
their eyes open do not perceive the objects nearest to them. The vital heat
being then collected internally, he adds, the powers of the digestive faculty
are increased. Rhases agrees with Galen, that moderate sleep forms good
blood ; but that too much corrupts the juices, that is to say, impairs diges-
tion. Haly Abbas remarks, that, during sleep, the animal powers are sus-
pended, while the vital and natural continue unaflfected ; and, therefore^ ihe
mind or principle of life being then disengaged, as it were, from one of its
offices, is the abler to perform the others aright. Hence, he adds, digastion
ia best performed during sleep. Alsaharavius approves of taking rest after
a meal, but recommends to allow an hour to elapse before going to sleep.
Although foreign from my purpose to indulge in frequent quotations from
authors not strictly medical, it may not be thought much out of place hoe
to set down the following encomiums on sleep by three of the greatest poets
of antiquity:—-
** 'Ym^ olfvpat iiarfS, *Ynvi ^ Sky^mfy
EvaM»v, hfoiuitv Svet^f
Of/LiuMtrt l!^carrl(rxois rM d^Xvr, a rerartu rav^." — Sophocles, Philoc,
** Q (f>iKov viTPov BfKyrjrpop, eirucovpov votroVy
'Qg ^du fioi irpoarjkoes iv htovri ye.
Q frorvla \rj0rf rav kok&v, ms ci (ro^y
Km ToifTi bvarruxoKriv ivicrala ^eor.**— -Euripides, Orestes.
** Somne quies remm, placidissime Somne Deorum,
Fax animi, quern cura rogit ; qui corda ditumis
Fessa ministeriis mtdces, repaivsqae labori." — Onn. Metam, xi.
The reader will find in StentzeVs little treatise, entitled AurrpiPrf wept rov
trrvovy an interesting exposition of the opinions of the ancient philosophers
and physicians on this subject.
COMMENTARY ON THE FIRST BOOK. 127
XCVIII.— ON WATCHrULNB88.
We have mentioned in the 74th chapter, that Galen cured himself of watch-
fulness by eating freely of Lettuces. See further Oribasius, Med. Colled,
lib. vi. — ^Averrhoes, Collectan, ii. 5. — Alsaharavius, Theor, xi. 3. — Rhases,
Continens. lib. xxxi.
Rhases recommends lettuces, the tepid bath, the effusion of tepid water
on the heady and diluted wine. He also recommends mandragora and opium,
which, he says, Galen states will produce soporific effects, not only when
taken internally, but when rubbed on the forehead, and applied to the nos-
trib. He particularly approves of the following Liniment : Pound the bark
of mandragora, the seed of black henbane, and opium, with the juice of let-
tuce, and rub into the temples.
XCIX. ON CATAPHORA, OR 80MN0LBNCT.
See the Commentary on the Chapters on Lethargy and Cams in
Book. III.
C. THE EPISTLE 07 DI0CLE8 TO KING ANTIG0NU8.
This Diocles was an ancient physician of great eminence. Galen often
mentions him along with his idol, Hippocrates, as the greatest of medical
authorities. Cselius Aurelianus frequently quotes his opinions in respectful
tenns, although belonging to a different sect from his own. Pliny says, that
he was next to Hippocrates in fame as in time. Octavius Horatianus calls
bim the Younger Hippocrates. Athensus mentions a work of his on Poisons,
and another on Cookery.
Le Clerc questions the authenticity of this Epistle, but seems to have had
DO other grounds for his scepticism Uian the general suspicion which attaches
to all the Epistols Gnecanics. It is published in the Biblioth^ca Graca
of Albertus Fabricius, who appears to have been satisfied of its genuineness.
Mr. Moir, the author of Outlines of the Ancient History of M^icine, con-
demns it as Apocryphal, upon the authority of Schulze, p. 76.
HEADS OF THE SECOND BOOK.
In this Book, which is the Second of the whole Work, the subject
of Fevers is treated of. — First, Of those things which relate to the
Bymptoms and general core of Fevers ; neat, Concerning the origin
and treatment of each particular Fever ; and, third. Concerning the
complaints which usually follow Fevers.
1. Preface to the Book on Fevers.
2. Of the principal considerations to be inquired into with regard to
Fevers.
3. From Galen, what to call the commencement of the Disease.
4. How to know whether the Disease will be fatal or not.
^' How to know whether the Disease will be of short or of long duration.
6. How to know if the Disease will terminate by a crisis or by resolution.
7. On Critical Days.
8. ' That the Critical Symptoms appearing in the commencement are unfa-
vourable.
9> How to judge beforehand of a future crisis.
10. How to recognise a present crisis.
H* How to know whether a past crisis be favourable.
^2. On Pulses.
13. On the Alvine Evacuations.
14. On the Indications from the Urine.
15. On the Indications from the Sputa.
16. Diagnosis and Cure of Ephemeral FeYen.
17. Diagnosis of Putrid Fevers.
18. Treatment of Putrid Fevers.
19. On the Diagnosis of Tertians.
20. The Cure of Tertians.
21. Cure of Spurious Tertians.
22. Diagnosis of Quartans.
23. Cure of Quartans.
24. Diagnosis of the Quotidian Intermittent.
25. Cure of the Quotidian.
26. On the Fever Hepialus, and Rigor without heat.
27. On Continual Fevers.
130
28. Cure of Synochous Fevers.
29. Diagnosis of Ardent Fevers.
30. Cure of Ardent Fevers.
31. On the Diagnosis and Cure of Fever connected with an Erysipelatous
affection.
32. Diagnosis of Hectic Fevers.
33. Cure of Hectic Fevers.
34. On Semi-tertians.
35. On Epidemic Diseases.
36. On the Plague, from the Writings of Ruffus.
37. On those that are seized vrith Syncope from a collection of crude
humours.
38. On those that are seized with Syncope from thin humours.
39. Concerning the other causes of Syncope.
40. On Pain.
41 . On Melting or Colliquative Diarrhoea
42. On Watchfulness in Fevers.
43. Cure of Somnolency.
44 . Cure of Headach in Fevers.
45. On the care of those things which relate to the Stomach.
46. On Inordinate Cold and Rigors in Fevers.
47. On Sweatings.
48. On Cough in Fevers.
49. On Sneezing.
50. On Loss of Appetite.
51. On Inordinate Appetite.
52. On Canine desire of Food.
53. On Thirst.
54. On Roughness of the Tongue.
55. On Nausea.
56. On Vomiting of Bile.
57. On Singultus, or Hiccough.
58. On Looseness and Constipation of the Bowels in Fevers.
59. On Bleedings at the Nose.
60. On Fainting, or deliquium animi in Fevers.
61. Cure of Ulceration over the Os Sacrum.
PAULUS iEGINETA.
BOOK SECOND.
I.— 0» Fevers J from tite Works of Galen and several others.
After having treated of those things which relate to the preserva-
tion of health, we now come to the treatment of persons already in
disease, beginning with homogeneous disorders as being the most sim-
ple. These are what are called fevers. Wherefore, using principally
Oribasius' Epitome from the works of Galen and several others on
this subject, we shall add a few things omitted by them.
II. — Of the principal Considerations to be inquired into with
regard to Fevers,
The first thing to be considered is, whether the disease will
prove fatal or not ; then, if it is not to prove fatal, whether it will
be acute or chronic (these considerations apply to other great dis-
orders) ; and, third, whether it will come to a sudden crisis (which
is peculiar to fevers), or be resolved locally.
III. — From Cralenj what to call the Commencement of the
Disease,
As headach is not the same complaint as fever, so neither are
iQsoninolency, loss of appetite, heaviness of the whole body, and a
^se of lassitude ; and yet each of these symptoms, although differ-
ent from fever, announces its approach. A fever setting in, and
^ore especially in an acute manner, cannot escape our notice, nor
e^en that of a person unacquainted with these matters. Or, if we
should suppose that it might escape us, I should wonder if the
k2
132 PAULUS ^GINETA.
patient himself could be ignorant of it for more than an hour.
Wherefore I call that time the commencement of the disorder,
•when those beginning clearly to be affected with the fever first be-
take themselves to bed.
IV. — How to know whether the Disease mil prove fatal ornot.
These are fatal symptoms : a deathlike countenance, sharp nose,
hollow eyes, and the other symptoms described by Hippocrates,
when they do not proceed from watchfulness, or evacuation, or want
of food ; also, intolerance of the light, shedding tears from no exter-
nal cause, and the eyes not retaining their proper expression, the
one eye appearing less than the other, or the white of the eyes be-
coming red, or livid, or black, or turning muddy ; and the white of
the eyes appearing during sleep, the eye -lids not being closed, un-
less this symptom proceed from a great evacuation, or from habit.
Likewise grinding the teeth, a state of delirium, picking at flocks of
wool, or bits of chafl^, are not favourable. Attention should also be
paid to the patient's mode of lying. To lie supine, as it were, in a re-
laxed state, and to sink downwards in bed, indicate the extremity of
weakness. It is still worse to have a cold respiration at the mouth
and nostrils; and a pulse obscure, dense, and intermitting, and profuse
sweatings with syncope are most mortal symptoms. If all these
symptoms or even more appear, or if they be fewer in number but
strong, and if they be without any favourable ones, death is inevit-
able. Tlie breathing free, pulse natural, soundness of intellect, being
disposed to take whatever food is administered, the appearance of
countenance and mode of reclining like those of persons in health, —
all these symptoms are favourable and prognosticate recovery. In
short, whatever symptom is contrary to the natural state indicates
an unfavourable, whereas what is corresponding indicates a favour-
able termination. Concerning the prognosis from the urine, alvine
discharges, and sputa, we will speak soon.
V. — How to know if the Disease will be of long duration.
The duration of the disease may be ascertained from four things —
from the movement of the disease itself, from the habit of the pa-
tient, from the pulse, and from the species of the fever. From the
movement of the disease thus : if the four periods of a particular
paroxysm have passed over quickly and in the least possible time,
the disease will be an acute one, the furthest bound of which will
be the seventh day, and generally will come to a crisis on the
fourth. If the periods of the first paroxysm occupy more time but
do not exceed twelve hours, the disease will still be an acute one,
which will terminate within the fourteenth day. If it extend
longer, so that the commencement and augmentation of the pa-
roxysm alone occupy a longer period than a day or a night, such a
BOOK SECOND. 183
disease will prove a long one. If the disease have no particular
paroxysms, but consist of one continued paroxysm from beginning
to end, as in synochous fevers, even in this case you may call the
disease an acute one. It may be judged of from the habit of the
patient : thus, if the face and the rest of the body are already con-
siderably reduced, an acute disease is indicated ; but if wholly unre-
duced, a chronic one ; for a great collection of offending matter is indi**
cated, which will require a length of time for its concoction. It may
be judged of from the pulse : thus, a great, strong, quick, and dense
pulse, indicates an acute disease, but the contrary a chronic. From
the species of the fever, inasmuch as hot and ardent fevers indicate
an acute, whereas gentler, and, as it were, smothered fevers indicate
a chronic one.
VI. — How to know if the Disease tvill terminate by a Crisis j or
by Resolution.
This may be ascertained from what has been already said, namely,
the species of the fever and its duration, and perhaps from the
species of the fever alone. For hot and ardent fevers are of short
duration, and have usually some cntical evacuation ; whereas the
gentler prove more chronic and terminate for the most part by ab-
scess. From what has been said, it appears that we may prognosti-
cate not only when the disease will come to a crisis, but also how it
will terminate ; for acute diseases generally terminate by evacuation,
and the chronic by abscess.
VII. — On Critical Days,
Op the critical days some terminate the disease frequently,
faithfully, well, completely, clearly, obviously, and others con-
tnoywise. But the 13th is known to possess an intermediate
character. Some of these are such as to prove critical if they ex-
perience even the most moderate impetus of nature, such as the 7th
and 14th ; whilst most of them prove critical in violent commotions
of the system but not otherwise. Neither are the favourable all
equally favourable, nor the unfavourable all equally unfavourable ;
nor is their favourableness and unfavourableness according to any
order. Those in the first rank of favourable days may be arranged
tbus : the best of all are the 7th and 14th, next to them the 9th,
and nth, and 20th ; and near to them the 17th and 5th, after these
the 4th, after it the 3d and 18th. — Opposed to them, of the second
rank are these. The worst, which proves obscurely critical with
(langer, and is as it were diametrically opposed to the 7th is the 6th.
Near to it are the 8th and 10th, after these the 12th, 16th, and
19th. Intermediate between these is the 13th, being neither so
ol^ectionable as those of the second rank, nor so favourably critical
as those of the first. The critical days then are thus arranged
134 PAULUS iEGlNATA.
according to their degree by Galen. Numerically thus : the favour-
able are the dd, 4th, 5th, 7th, 9th, 11th, 14th, 17th, 18th, 20th;
the unfavourable, the 6th, 8th, 10th, 12th, 16th, 19th; the inter-
mediate, the 13th. Some of the critical days give information con-
cerning the others, and are hence called Indicatory by Hippocrates,
because they indicate the crisis that is to happen on another critical
day. Thus the 4th indicates a crisis on the 7th, by inducing sweats,
perspirations, or some such particular evacuation, or by displaying
certain signs which had not formerly taken place, or some symptoms
of concoction. Galen says, that the 4th is indicatory of the 6th, al-
though it be unfavourable, as the 1 1th is of the 14th, and the 17 th of
the 20th. Until the 14th day the crises are the most decided, next to
these until the 20th, — from the 20th to the 40th they gradually lose
their decided character. Of these, the first in degree are the 27 th, 34th,
and 40th, after which are the 24th and 3 2d. The other numbers
intermediate between the 20th and 40th are indeterminate, and those
after the 40th are not properly critical, as they terminate diseases
by concoctions and abscesses rather than by crises. Hippocrates
seems entirely to disregard all those after the 40th day, yet he
enumerates the 60th, 80th, and 100th. After these, he says that
some diseases prove critical in seven months, some in seven years,
and others as it would appear in twice or thrice seven years.
VIII. — That Critical Symptoms appearing in the commence-
ment are unfavourable,
Thb signs of concoction are never unfavourable, for concoction
always takes place when nature prevails, and therefore the signs of
it are always favourable. But the critical signs may sometimes ap-
pear unfavourably, owing to the crisis partying of a double cha-
racter (as was said with regard to the critical days), being sometimes
favourable and sometimes unfavourable. They ought not therefore
to appear at the commencement, nor during the increase of the dis-
ease, but after its acm^, at which time nature is prevailing over the
disease.
IX. — How to judge beforehand of a future Crisis.
If the paroxysms increase in violence, and occur earlier and
become much stronger; if they invade on the third day; and
if symptoms of concoction appear in the urine, alvine discharges,
and sputa ; the disease will certainly soon come to a crisis. If the
attack is slow, and if the paroxysms occur at the same hour every
day, you may expect that the crisis will not take place till after ft
longer time. And those fevers which make their attack with,
rigors cannot terminate until the rigor abate ; for until that oc-
cur it is impossible for the disease to have attained its acm^, and
therefore much less is it reasonable to expect that it is upon the
decline.
BOOK SACOND. 135
X. — How to recognise a present Crisis,
Rs8TLB88NB8s precedes every crisis, and if the crisis be to take
place by day, it will occar by night, or if the crisis be to take place
daring the night, it will occur by day. Then certain symptoms sa-
pervene, such as headach not previously occurring, sympathetic
pain of the neck, retraction of the hypochondrium, sudden difficulty
of breathing, and other dangerous symptoms which did not mani-
fest themselves before. And if, when these occur, the pulse instead
of sinking is increased in magnitude and becomes stronger, and the
critical day approaches, and if it be one of the favourable, you may
not only anticipate a crisis but also a good one. And be not then
alarmed if you see the patient become delirious and disturbed, for
these are indications of the humours being carried upwards ; in like
manner as certain other symptoms indicate their being determined
downwards, such as pain in the bottom of the belly, gripes about the
navel, pain in the loins, borborygmi, and other similar symptoms.
In addition to these, if the patient was accustomed to have a hae-
morrhoidal discharge, and if the period of it be at hand, and in like
manner with respect to the menstrual discharge (if the patient be a
woman) it is not unlikely that the crisis may take place by such an
evacuation. — And a critical sweat is recognised by a precursory
moistness of the skin (especially if occurring upon one of the days
called indicatory), and by openness of the pores. From these you
may recognise crises by evacuations upwards. For, in addition to
the aforesaid, you ought to examine the face of the patients, and
whether there be palpitation in any part, or throbbing of the tem-
poral arteries ; or if the cheek, nose, or eye be redder than usual,
you ought the rather to anticipate the coming crisis ; but if they shed
tears involuntarily, or fancy that they see sparks of light, and con-
stantly carry their hands to their nose as if to rub it, then indeed
you may see not only an approaching but a present flow of blood .-^
Por when they rub it once or twice the ^blood straightway breaks
forth. Pungent pain at the stomach, and trembling of the under-lip
often indicate a crisis by vomiting. These considerations are suf-
ficient, but to them may be joined the age and constitution of the pa-
tient, as strengthening the anticipation ; to which may be a(fded, the
season of the year and the present constitution. For if the patient
1)6 a child, or otherwise by nature warm and full of blood, you may
still more form this anticipation ; or if formerly when in health or
disease, as we remarked before, an evacuation of blood appeared, this
circumstance alone may be sufficient to make you expect an he-
morrhagy. And if the season of the year be summer, or, if not sum-
mer, if the present state of the weather be hot, and if the patient
had often experienced a crisis at that season by hemorrhage, if the
body be plethoric, if there is retention of the customary evacuations,
all these things ought to strengthen your expectations. In like man-
ner you ought to judge of the other evacuations. Or, if none of these
sirmptoms should appear, but if there be uneasiness occurring on one of
136 PAULUS iSGINSTA.
the critical days after the 20th ; or if, when the disease is at its acm^,
pains should seize certain joints, or near the ears, or in other parts ;
or if not pains, but local sweats should occur unceasingly in any
part of the body; then indeed you may expect a crisis to take place by
abscess, and in that part where the sweats, pains, or swelling oc-
curred.
XI. — How to determine whether a past Crisis be favovrable.
If a proper evacuation takes place after the concoction, and the
fever is resolved by the critical evacuations ; if the patient is freed
from all other symptoms ; if his colour has improved in proportion
to the evacuation ; if his pulse has become more regular, and his
strength better ; and, what is the most salutary symptom of all, if
these are accompanied by repose of the constitution, this may be
pronounced to be the best possible crisis. If any of these be want-
ing, the goodness of the crisis will diminish proportionally.
XII. — On the Pulse^ from the Works of Galen,
The pulse is a motion of the heart and arteries, accomplished by
a diastole and systole. Its use is two-fold ; for, by the diastole,
which is, as it were, a distension and expansion of the artery, the
cold air enters, ventilating and resuscitating the vital power, and
hence the formation of the vital spirits ; and by the systole, which
is, as it were, a falling down and contraction of the circumference
of the artery towards the centre, an evacuation of the fnliginoua
superfluities is produced. The arteries themselves are oblong hol-»
low vessels like the veins, but consist of two coats, in order to fit
them for the afore-mentioned motion, and because they have to
contain blood and spirits. They arise from the heart, and are
distributed to all parts of the body ; and, therefore, all the arteries
pulsate in a similar manner, and like the heart, so that from one
you may judge of all the rest. But the motion of all cannot be
equally well observed ; for those which are situated in parts that
are not fleshy may be easier felt than those in fleshy parts. Nor is
any one more conveniently situated for being felt than the one at
the wrists. The First kind of pulses is in regard to the time of
their motion, as observed in systole and diastole. Their differences
are, the quick, slow, and moderate ; because every body which is
moved must be moved quickly, slowly, or intermediately, as to
time ; that is quick which is moved over a great distance in a short
time ; that is slow which is moved over a short distance in a long
time ; and that is moderate, whose motion is intermediate. The
Second kind of pulses is in regard to the extent of the diastole.
For, since every body has three dimensions, length, breadth, and
depth, and an artery is a body, it follows, that an artery must have
these dimensions. When, therefore, an animal is in its natural
BOOK SECOND. 137
state, you will find its arteries dilated moderately every way ; but
when not in its natural state, its dilatation will be deficient, or exceed
according to some one of its dimensions. In calculating this, you
must remember the natural state of the pulse ; and if it is found to
exceed in breadth, you must call it broad, if in length, long, and if in
depth, high, or deep. It is clear, that the opposites to these, or those
that are deficient, are the narrow, short, and low. And with regard
to those which are altered from the natural state in all their dimen-
sions, that which is every way diminished is called small, and that
which is every way increased, great. The Third kind is with re-
gard to the tone of the vital strength. The varieties are three, the
strong, the tpeak, and the moderate. The strong is that which strikes
the finger of the physician strongly, and the weak, feebly and faint-
ly ; while the moderate is intermediate between them, and is held
by some to be the natural one ; for, that a strong pulse is occa-
sioned by passion and baths and is not natural. In reply to which,
Galen contends, that a pulse, rendered stronger by non-natural
causes, soon undergoes a change ; and that, therefore, a strong
pulse, which does not readily change, is natural and moderate.
The Fourth kind is in regard to the consistence of the instrument,
I mean the body of the artery. In this respect there are three dif-
ferences ; for the artery is either harder than natural, and is called
a hard pulse, or softer, and is called a soft, or intermediate, and is
called in this respect moderate. The Fifth kind is in regard to the
contents of the artery ; and their dififerences are, the full, the empty,
and the moderate, since every vessel must be full, empty, or mo-
derately full of liquids. A fall pulse, then, as Archigenes defines it,
is one which indicates an artery that is completely fuU, and the im-
pression of which is, that it is distended with fluids ; and an empty
one conveys an impression, as if its contents were full of bubbles
of air, so that the finger, when pressed upon it, seems to fall into
an empty space. These five kinds of pulses regard one motion of
the artery. And since the quality of the heat in the heart may be
more apparent than usual in the artery, some have hence formed
a Sixth kind of pulses. Of the other kinds, whether they are in
regard to one or more pulsations, they derive their character, either
from the time of rest, or the rhythm, or their equality and inequality,
or their regularity and irregularity. The kind, then, in regard to
the time of rest, which is the Seventh in order, is divided into the
dense, the rare, and the moderate. And, since an artery has a
double motion, composed of two opposite motions, it must of ne-
cessity have two seasons of rest, the one after the diastole before
the systole, the other after the systole before the diastole, which
many people affirm cannot be perceived ; and, therefore, the inter-
val of rest between two motions has been chosen. When, there-
fore, there is a long interval of rest, the pulse is called rare, when
short, dense, and when intermediate, moderate. The Eighth kind is
in respect to rhythm. Rhythm, then, in general, is the ratio and
proportion of one time to another. In regard to the pulse, it is,
acceding to some, the ratio of the time of motion to the time of
138 PAULUS iEQlNETA.
rest, as of the systole and diastole, to the intermediate time of rest ;
but, according to others, it is the ratio of a time of motion and rest
to another time of motion and rest, or of motion to motion.
Of rhythm, then, there are two varieties, the proper, and the
improper rhythm. Of the improper, there is a threefold difference ;
first, when there is a slight departure from rhythm ; second, when
there is a greater; and, third, when there is no rhythm at all.
Thus, for example, in a child, if his pulse has the rhythm of child-
hood, it is called its proper rhythm, if it has that of an adult, it is
said to be an improper rhythm, or if it preserve no ratio at all, it is
said to be without rh3rthm.
The Ninth kind of pulses is found in all the other kinds already
mentioned ; namely, that which regards equality and inequality,
which may be remarked either in one pulse, or in many, which last
is called the Systematic, and of which we must speak more clearly.
An equal pulse, then, is that which is alike in order, as regards
magnitude, strength, frequency, and certain other, or, indeed, all
its other characters. The unequal pulse, is that which is unlike in
order. For, if all are alike, as, for example, all deficient in mag-
nitude, such a pulse is called equal. But if the first, second, and
third appear alike, but the fourth unlike, it is clear that such a
pulse is unequal as to magnitude. Of this kind are the intermitting
and the intercurrent. For not only after one or more great pulsa-
tions may one smaller occur ; but sometimes this motion is wholly
wanting, and the pulse is said to intetmit. The other kind, the in-
tercurrent, is the opposite to this ; for, when we are expecting an
interval of rest, a supernumerary pulsation, as it were, occurs.
When the second is a little smaller than the first, and the third than
the second, and the fourth than the third in like manner, and so on-
wards, such pulses are called sharp-tailed or myuri, deriving their
names ^om figures terminating in a sharp point. Such as are al-
together diminished, and never cease from this state, terminate in
a total loss of motion, and aie called failing, or fainting myuri.
There are two varieties in respect to those which fail, for some of
them persevere in that state of smallness in which they terminated,
whilst others attain again their original magnitude, or nearly so,
or perhaps a greater, and these are called recurrent myuri. Pulses
also are called myuri, from their inequality in regard to one pulsa-
tion, concerning which we will speak presently. And this is the
nature of that inequality of pulse, called Systematic. But that
which takes place with regard to one pulse, or one part of an artery,
or more, as perhaps with regard to motion, for the inequality is ob-
served on one part of the artery, when the motion of the artery
upon the finger begins one way and terminates another, beginning
quicker, and terminating slower, or reversely. This happens in a
threefold manner, the motion either remaining constant, or being
interrupted, or recurring and beating double, as it were. If, then,
remaining constant and uninterrupted, it should change from quick-
ness to slowness, or conversely, such a pulse is said to be, and is of
unequal velocity. But if, after being interrupted by an interval of
BOOK 8£COND. 139
rest, it again appear quicker, it is called the goat^Uap or dorcadissana,
the term being derived from the animal dorcas, which, in jumping
aloft, stops in the air, and then unexpectedly takes another and a
swifter spring than the first. But, if after the diastole it recur, and,
before a complete systole take place, strike the finger a second
time, such a pulse is called a reverberating one, or dicrotos, from its
beating twice. You may see such a thing take place upon a stithy,
when a hammer, swung by the hand, first strikes the stithy, and
afterwards, recoiling from the re-action of the stithy, strikes it of it-
self a second or third time. And not only may an inequality as to
the time of motion take place as to one pulsation in one part of an
artery, but also in regard to the strength of the power ; not so,
however in regard to the extent of dilatation (for it is impossible
that the same pulse in the same place should be great and small at
the same time), nor in regard to the other kinds of pulses. But in
different places different parts of an artery may exhibit a double
inequality in one pulsation. For the motion may continue constant,
and be swifter at one finger and slower at another ; or, it may in**
termit, and one finger may perceive it, and another not. And also,
in r^ard to the extent of the diastole, the same inequality becomes
apparent in diffident places. Of this kind are the myuri, diminish-
ing once and again at one pulsation ; for, if at the inner finger the
pulse should be great and swelled up, but under the external at the
thumb of the patient it appear smaller, such a pulse is called myn-
rus, from its resemblance to the tail of a mouse — or meiurus, from
its being diminished like a tail. But, if the pulse appear great, and
swelled under the middle finger, but smaller on each side, Archi-
genes called this pulse innuens et circumnuens, i.e. the declining, and
the declining on both hands, wishing to mark the smallness of the
diastole, with the declination, as it were, of the two extremities ;
for these parts do not appear as if they were cut short, but as if
they were bent in and a little contracted on each side, and hence
the pulse is curtailed (myurus) on both sides.
And when the inequality as to magnitude takes place at different
times, such pulses become undulatory and vermicular. And if irre-
gularity of position be joined to them, they are called spasmodic
and vibratory. Let us begin with the undulatory, in which the
whole artery is not dilated, at the same time, according to the same
inequality, but this part of it first, that second, that third, and that
fourth, the motion continuing constant like the swelling of the
waves. And some have the wave carried straight forward, some
obliquely ; some have a sufficient altitude in a short expansion as
to length, and some conversely ; some have a broad, and some a
narrow, and they have the like inequality in regard to quickness
and strength. When the undulatory is wholly diminished in size,
it is called the vermicular, which resembles the motion of a worm.
As the undulatory pulse, when it goes on diminishing, terminates in
the vermicular, so in like manner does the vermicular in the ant-
like, when, most <^ its motions being lost, it terminates in one, and
it a very- small motion. It is called formicans from its resemblance
140 PAULU8 ifiGlNETA.
to the ant {formica), on account of its smallness and kind of mo-
tion. The ant 'like or creeping pulse (called formicans) is very
small, there being none smaller than it ; and, in like maimer, it is,
of all others, the most indistinct and dense, but is not quick as
Archigenes supposed. Nearly allied to it is the hectic. For, as
there is a hectic fever, so is there also a hectic pulse, which under*
goes little or no variation, but remains always the same as at first,
contracted and never expanding, the whole habit being turned into
disease. The spasmodic pulses appear as if they were dragged,
stretched, and drawn by the extremities, conveying the sensation of
a stretched cord. But no such thing takes place in the vibratory;
for, in them the dilatation is greater, as if different parts of the
artery were carried upwards at one and the same time. They may
be resembled to darts, which, when thrown with force, are carried
along with a vibratory motion. The pulse is serrated when part
of the artery seems to be dilated, and part not ; the artery itself
also appearing to be harder than natural. This pulse has some of
the characters of the vibratory, and is quick and dense, but not al«
ways great. In addition to those mentioned, there is a tenth kind
of pulses arising from inequality, namely, relating to regularity and
irregularity. The unequal pulses being divided into those which are
alike as to periods, and those which are wholly unlike, the regular
and irregular are formed according to each of these divisions ; from
the equality of periods, the regular is formed, and from the entire ine-
quality the irregular. The equal pulse is also always regular (since
consequently we call it alike) ; but the unequal is not altogether irre-
gular, for, supposing it to have no equality, and yet to preserve a cer-
tain period, such, for example, as to extent of diastole, if there are
two great and one small, then again two great and one small, and so
on successively, such a pulse would be called anomalous, that is to
say, unequal, but regular. But, if it not only had no equality, but
likewise no order in its inequality, such a pulse would be not only
unequal, but also irregular, and in like manner with regard to the
other kinds. Of the irregular, some are altogether so, observing no
period whatever ; others are indeed regular as to periods, but, having
no continued order, they may, in this respect, be called irregular*
but in so far they observe a certain period regularly, they being regu-
lated as to their periods. As if, for example, there were two great
and two small, then three great and three small, and four great and
an equal number small ; and, returning again, two great and two
small, three great and as many small, and so on in like manner.
It is to be remarked, that, of all the other opposite kinds, there is
one intermediate between the two extremes, but that there is none
between the equal and unequal, and the regular and irregular, un-
less you choose to call the one which is regular as to periods the
medium between the regular and irregular. And the intermediate
pulses of all the other kinds are the natural, except that which
relates to strength and weakness, as we showed. But, in those
we have been describing, the equal alone is the natural, and all the
others are not natural, namely, the unequal, the regular, and the
BOOK SECOND. 141
irregular. These are all the kinds of pulses and their generic dif-
ferences. Some add two others to these, the one in regard to the
position of the artery, according as it seems to he carried upwards
or downwards, to the right or to the left, and the other in regard
to the times of expansion. But these we treated of along with the
uidulatory and the vihratory. And we, for the sake of hrevity,
have only delivered the simple varieties ; hut, from what has been
said, one may easily cmnect them^^ and discover those which arise
irom their combinations.
The causes affecting the pulses are next to be treated of,
with which is connected the prognosis from them. We shall
begin with those which respect magnitude, because it is more ob-
nous than the others. A great pulse is produced either by some
argent necessity, such as an excess of heat in the heart re-
quiring refrigeration, and as it were ventilation from without ; or
it may arise from leanness of the body, as we shall soon show.
The excess of heat is occasioned either by natural causes, such as
the ages of manhood and youth, or simply a hot season, place, or a
warmer temperament; or by non-natural causes, such as the air
which surrounds us being hotter than common, hot baths, exercises,*
food, wine, heating medicines ; or by preternatural causes, such
as a hot intemperament, putrefaction of the fluids, passion, or the
like. You may judge of these classes of pulse from the following
observations. Those which are natural are permanent and not
rery susceptible of change, whilst the others readily change, so that
often while you examine them, or generally after a very short time,
they will altogether alter. A pulse also which owes its greatness
to a hot bath has softness for an accompaniment ; and hardness
is generally combined with greatness proceeding from a hot in-
temperament, especially when combined with dryness of the sys-
tem. Those who have undergone moderate friction or exercise
have a pulse intermediate between hardness and softness ; but they
have the parts about the chest warmer than natural, which is the
case also with those in a passion. Those that are influenced by
food, the use of wine, or rage, have vehemence joined to greatness.
Those who wish to conceal anger, or something which they have
done without permission of the physician (such as if a person has
taken a heating medicine, and wishes to conceal it from the physi-
cian, who inquires about it while he feels the pulse), in such per-
sons, a manifest inequality is joined to greatness. To the discovery
of this state, other considerations may contribute, such as the habit
of the patient, as if he appeared to be fond of taking medicines, or
his disposition, as if it be bad, and cunning at concealments. A
pulse which is great from putrefaction of the fluids has joined a con-
traction more hasty than natural to its greatness. To form a great
pulse, an urgent necessity is not alone sufficient; but the vital powers
must also contribute, and a condition of the instrument or artery in-
termediate between hardness and softness. When the heat, therefore,
is increased in the heart by any of the above-mentioned causes, in
the first place, the pulse becomes great, and, the greatness not being
able to supply the want, quickness is straightway joined to it ; and,
142 PAULUS iEGINETA.
if that is not sufficient, density is superadded. But small, slow,
and rare pulses are formed by the opposite causes. But, when a
change first takes place from a great, quick, and dense pulse to
their opposites, namely, when the necessity is at an end, the first
character of the pulse is not the first that leaves it, but it loses first
that which it last acquired, becoming first rare, then slow, and last
small. But, if the slowness and smedlness should go on increasing,
the rarity will again change to density, in order that the necessary
want may be supplied. Such are the causes of greatness, quick-
ness, density, and their opposite pulses. To these we shall con-
nect the alteration of the pulse in regard to one dimension only.
Breadth alone then is increased, principally by a redundancy of
humidity, either natural, or from external causes, as loftiness is oc-
casioned by the softness of the instrument, assisted by the vital
power ; but length is rendered apparent, by the dr3mess and melt-
ing of the surrounding flesh, the other dimensions being contracted.
For an artery cannot, in fact, become longer than natural ; and this
ought more properly to be called the lean pulse, as the opposite one,
namely, that which is increased only in breadth and depth, should
be called the fat. The pulse sometimes falls under the opposite
characters to this, when it is restrained as to any of its dimensions,
and appears low, narrow, and short, when it is not so in reality,
but seems so, owing to the thickness of the fat, flesh, or membranes
which press upon it. Sometimes, too, the whole seems small,
when it is not so in reality ; and feeble in like manner. And what
do I say? Sometimes an asphyxy, or complete loss of pulsation,
hath seemed to take place over the whole arteries, when there is
no such thing in reality ; and this has happened, more especially to
those who have felt them carelessly, when the motion, being really
indistinct, escapes notice, owing to the quantity of flesh ; for it is
impossible that a complete a8ph3nEy could take place while the man
is alive. In like manner, again, in the emaciated, small pulses ap-
pear great. When, therefore, the body is greatly wasted, the ar-
tery which runs along the spine has often been felt by those who
touch the abdomen, and also the pulses in members which be-
fore used not to be felt. Wherefore, we must attend to all circum-
stances, that we may not be mistaken in our diagnosis. A strong
pulse is occasioned by the force of the natural faculty, when not
counteracted by any other cause, such as the want being faint,
or from hardness of the instrument. But a feeble pulse may arise
from weakness of the natural powers alone, although no other causes
contribute. For a strong pulse stands in need of all the other
causes for its formation ; but the feeble is produced by weakness
alone. The originally strong pulse accompanies moderate ages,
seasons^ j^aces, and temperaments ; but the feeble the immoderate.
A pulse changing from feebleness to strength is formed by the
vital faculty growing strong, from a preceding state of debility. It
is strengthened either by things within the body, such as concoc-
tion of the fluids, or an excretion of them, or passion ; or by ex-
ternals, such as wines, food, exercises, and whatever will rectify
BOOK SECOND. 143
the intemperament. The natural powers are weakened by want of
food, watchfulness, immoderate evacuations, grief, cares, and more
especially pains inducing syncope, and whatever forms an intem-
perament. Some inexperienced persons have thought a hard pulse
strong, but a person of experienced understanding and touch will
not mistake them ; for a strong pulse, being mostly accompanied
with greatness, is swelled up to loftiness and strikes the finger
forcibly ; but the hard does not admit of greatness, on account of
the unyielding state of the artery. Wherefore, a pulse becomes
bard, owing to the hardness of the artery. This is occasioned by
immoderate cold, or dryness, or tension proceeding from inflamma-
tion or spasm. To the hardness are straightway joined smallness,
quickness, and sometimes density instead of greatness, owing to
the exciting want. A soft pulse follows a humid state of the ar-
tery. An artery is rendered more humid by things not preternatural,
SQch as more liquid food, immoderate baths, much sleep, a more
abundant diet, and hilarity ; and by preternatural causes, such as
coma, lethargy, dropsy, and the other pituitous affections. A full
pulse indicates an abundance of fluids, or plethora from food, or
from drinking wine, as the empty on the other hand indicates de-
ficiency of food or evacuation. When the body of the artery feels
warmer under the finger, tiiis indicates great heat in the heart,
while the rest of the body is cold, or a certain spasmodic state of
the arteries, which are warmed by the violent motion. Archigenes
says, that the place of the artery will particularly be found warmer
in catochus, and in those who are about to be affected with somno-
lency. With regard to rhythm, when the ratio of the times of
motion and rest is equal, it indicates a proper temperament of the
body, or no great departure from it, as in early age, and the otherwise
well-regulated bodies. But, when the time of rest is greater than
that of motion, this indicates that heat prevails, as in adults and
those of the adjoining ages ; as, in aged bodies which are entirely
eold, the time of motion is greater than that of rest. It is to be re-
marked, that inequality in regard to rhythm, being the measure of
that as to quickness and density, this holds the place, as it were, of
the materiel to the rhythm.
The intermittent and intercurrent pulses take place when the
powers are oppressed, and, as it were, borne down ; but the inter-
current indicates a lesser, and the intermittent a greater injury.
And, in general, that state in which the powers are oppressed and
borne down, changes the pulses to inequality and irregularity in
every other respect, and also in regard to strength and greatness.
The pulses called myuri, being shown to be of two kinds (for they
are found either in that inequality called systematic, or in regard to
one pulsation), the failing or fainting evince the last prostration of
the powers ; but, when they return, or are recurrent, they indicate
that the powers are weak, but that they are struggling, contending,
and have not yet submitted. As to the myuri, in regard to one
pulsation, called the failing, and the failing on both hands (innuentes
et circumnuentes), these happen to persons who are gradually wasted
144 PAULUS iEGINETA.
by inflammations not yet resolved, and to those who waste from
whatever cause* the bodies around the arteries being melted down.
Pulses of unequal velocity, and those called dorcadissantes or gout-
leap, principally accompany febrile heat. But, if the pulse be faint
at the commencement of the diastole, and increase in velocity to-
wards the end and beginning of the systole, this indicates that
putrefaction is prevailing, nature hastening on the discharge of the
fuliginous superfluities. But if, on the other hand, it be faint at
the commencement of the systole, and rather make speed towards
the diastole, you may be sure that the heat is prevailing, and long-
ing for refrigeration. These in fever are, for the most part, ac-
companied by density, and sometimes greatness, if the powers he
not restrained by the hardness of the instrument. When the hard-
ness of the artery increases, and the powers are not weakened, the
double or reverberating pulse is formed. The undulatory pulse most
commonly attends the more humid aflections, such in particular as
anasarcous swellings, lethargy, and peripneujnony. When the
powers of life are beginning to fail, but are still making a faint
struggle, the undulatory pulse sinks into the vermicular ; but, when
they decline to their lowest ebb, this last passes into the ant-like
or formicans. The hectic particularly attends those in consump-
tion and marasmus. The spasmodic pulse takes place when the
origin of the nerves is suffering from some inflammatory aflection,
as in phrensy and acute attacks of epilepsy, when those aflfected
with them die while they are yet warm, contrarywise to those in
syncope, for they are alive after they have become cold. The
clonodic or vibratory pulse takes place when the wants of the system
require a great diastole, and the vital powers are sufficient for that
purpose, but are opposed by the body of the artery ; which, from its
hardness, cannot be expanded to a large diastole, as happens in
great inflammations and chronic obstructions. The serrated pulse is
indicative of inflammation, and particularly in some tendinous part. It
is no less so of pleurisy, and when slight, it indicates that the inflam-
mation is gentle, and easily to be concocted; but when intense, that it
is severe and of difficult concoction, and will be attended with urgent
danger, if the powers be weak, or, if they be strong, that it will be
slowly concocted, for it will either terminate in empyema, or a con-
sumptive marasmus will supervene. One ought also to know, that
irregularity of the pulse commonly accompanies its inequalities ; for
you will rarely find an unequal pulse orderly. Wherefore, the
lesser constitutional injuries occasion unequal and regular pulses,
but the greater, the unequal and irregular.
These are the simple causes of the pulses and their prognosis,
and from them the compound, as we stated when treating of their
differences, may easily be discovered.
XIII. — On the AMne Discharges.
Of the alvine discharges, the best is that which is soft and com-
BOOK SECOND. 145
pact» and is evacaated at the hour which is customary in health.
Such excrement is yellowish, of the proper consistence, and not very
fetid ; for whatever is different from these is not good. That which
resembles in colour the food which has been taken, or is thin, wants
the natural juices, and is passed quickly, is indigested. But that
which is very yellow, if evacuated in the beginning of a disease, in-
dicates that the complaint is of a very bilious nature ; but if after
the acm^, that the body is properly purged. The green is indica-
tive of violet-coloured bile, but the black of black bile, or of adust
blood mixed with it. The livid marks a coldness and considerable
mortification of the internal parts. The oily is indicative of a melting
of the fat in the body ; as the glutinous, which is worse than the oily,
indicates a melting of the parts of the animal. That which is very
fetid indicates no small degree of putridity. With regard to them
all, if the quality of the excrements does not correspond with the
food which had been taken, judge from hence of the affection. Of
all kinds, the worst and most fatal is black, livid, oily, and what is
hastily passed.
XIV. — On the Indications from the Urine.
As concerning the alvine discharges, so also with respect to the
orine ; using that of healthy persons as a rule, we shall hence form
our indications of that of persons in disease. That urine, therefore,
is best, which is nearest to that of healthy persons. Such is that
which is at the same time somewhat tawny and yellow, and which
straightway attains a proper consistence. There are three varieties
of turbid urine ; for either straightway after being voided it deposits
a sediment, or it always remains the same, or it is voided pure, but
sfterwards becomes turbid ; of these, the third is bad, the first favour-
able, the second intermediate between them. That which is wholly
unconcocted, being altogether watery, is symptomatic of digestion
bdng entirely gone in the venous system. But when it is passed
frequently, the disease is called diabetes, which is the worst of un-
Qoncocted urines. Next is the thin and white urine, which resem-
Ues water. Nearly allied to these, is another kind of urine, appear-
ing in many diseases, and which is very like to the thin and white.
The palish is next to this. The pale may also be somewhat tawny,
and is concocted in proportion as it partakes of this colour. It
ought,^ however, to be as much different from water in thickness as
in colour, if it is to be properly concocted. But if it preserve ex-
actly its natural colour, and have a white, smooth, equable, and
copious sediment, it is indicative of perfect digestion. A greater
quantity than natural indicates that a crude humour is purged off ;
but if it is somewhat thicker than natural, and has a certain sedi-
ment, it is not then altogether unconcocted. But if it have farinaceous,
scaly, furfuraceous, black, livid, green, or fetid sediments, such urine
is altogether unconcocted and mortal. But urine of a proper colour,
and which at the same time has white, smooth, and equable sedi-
L
146 PAULIJS iEGINETA.
ments, or certain cloud-like appearances, or substances swimming
in the middle, is of all others the best. Of these characters, the
sediment is of the most importance ; next, the substances swimming
in it ; and, third, the cloud-like appearances on its surfttce. In fine,
of those things which float in the urine, the more they subside
downwards so much the better.
XV. — On the Indications from the Sputa.
Such as are somewhat yellow, tawny, frothy, and thin, indicate
only want of concoction, but nothing else positively bad. But such
as are purely yellow, tawny, frothy, green, viscid, round, and
still more the black, are positively bad. For, with the exception of
the blood, whatever of the other humours is unmixed, indicates a
bad diathesis, having its origin in an inflammatory heat. Tiie
bloody sputa are of an intermediate character, but those of yellow
and black bile are unfavourable. The manner in which they are
brought up, ought also to be considered ; for, if they are readily spit
up, it is clear that such are good, whereas the contrary are bad. It is
an indication of complete concoction that the expectoration is unctuous,
white, and equable, and in consistence, neither fluid nor very thick ;
as it is of a complete failure of concoction that is not spit up at all.
If it is indeed spit up, but thin, it is a mark of feeble concoction. If
it is of an unmixed tawny or yellow colour, it is not good. - But if
it is livid, of a violet- colour, or black, it is a most fatal symptom.
XVI. — TJie Diagnosis and Cure of Ephemeral Fevers.
It is a peculiar and inseparable symptom of ephemeral fevers^
that concoction of the urine takes place on the first day ; and a plea-
sant state of the heat is likewise a peculiar and inseparable S3rmpr
tom. After the first solution of the fever, you will have a still
more confident diagnosis; for the motion of the arteries then becomes
similar to that of persons in health, whereas no other fever returns
so soon to the natural state. And it is aho a great mark of this fever,
that the patient bears it well. They are readily seized with this com-
plaint in whom the perspirations are not vaporous, but acrid, as If
containing something fuliginous. Such are they who are of a hot
and dry temperament, and are altogether much troubled with bitter
bile. Those who are seized with this fever from fatigue, should be
rubbed softly with oil and bathed ; but those from dryness, are to be
rubbed less and bathed more. Those from care, grief, watchful*
ness, or anger, are to be bathed, yet not often, but slightly rubbed
with plenty of tepid oil, possessed of little stypticity ;" and bathed
according to habit. Those who have been seized with the fever
from beat, are straightway to be treated with cooling remedies and
more baths, but, by no means, with much oil and friction. The
cooling remedies are to be rose oil, or cold oil of unripe olives, pre-
BOOK SECOND. 147
pared withoot salts. The same are to be poured upon the open of
the head, and the hath used when the fever has passed its acmd. If
a person has fever from cold, he is to be bathed in the decline ; but
if the fever be attended with catarrh, he is not to be bathed until
concoction take place : but those who have fever from a hot cause
are to be bathed while these symptoms are present. Those A-om
cold, are to be warmed moderately, and have the head bathed with
sach applications as the oil of iris and of nard. To those in whom
the fever is occasioned by constriction of the skin, the proper reme-
dies are, baths of tepid sweet waters, attenuant friction, exercises,
and an exhilarating diet. Those in whom the fever is occasioned by
want of food, are to be led to the bath after the decline of the first
paroxysm, and to have plenty of tepid oil poured upon them ; are to
be rubbed most gently, and to remain for the greater part of the
time in the cistern of the warm bath. After coming out and re-
covering their strength, they are to be led again to the bath, and
afterwards get warm water to drink, the juice of ptisan, and some-
times of lettuce ; and are to take of fishes having tender flesh, in
white broth. The common diet in all these cases ought to consist
of things which contain good juices, of easy digestion, and which
will not be restrained within the pores of the skin. Wine should
be given which is watery in appearance and strength. It will some-
times be proper, on the first attack of the fever, to give some
nourishing food, when the fever has been enkindled by an intem-
perament inclining to the hot and dry. Those who have this fever
from inflammation of the glands of the groin, do not require a phy-
sician to instruct them what ought to be done ; for, attending to the
ulcer from the time that the bubo is formed, they take the bath in
the decline of the paroxysm. But they ought to be restricted as to
wine, ontil the inflammation of the groin is resolved, and use a
spare diet.
XVIL— 0» Putrid Fevers.
Thk diagnosis of fevers from putrefaction is formed from observ-
ing that none of the procataratic or exciting causes had preceded ; and
it is peculiar to fevers from putrefaction, that they do not commence
with rigors, being preceded neither by strong heat nor cold ; and
compression of the pulse is also peculiar to them. This is the name
given to the pulse, when in the commencement of the paroxysm it
m very small and irregular. This is a well-marked peculiarity of
such fevers. But the strongest chfu'acteristic of putrid fevers is, the
quality of the heat ; for it is fuliginous so as to prove pungent to the
touch. Want of concoction in the urine and feeble digestion are
also peculiar to them. For, in such fevers, a strong and distin-
guished appearance of concoction in the urine is never to be seen at
first.
l2
148 PAULUS .fiGINETA.
XVIII.— 7%e Cure of Putrid Fevers.
When the powers of the constitution are strong, a person affected
with a putrid fever ought to be bled in the commencement, provided
there be no crudities in the stomach. But when the powers are
weak, or the age of the patient is an objection, you must not bleed.
After the evacuation by bleeding, it will be proper to clear away
the putrid matters by urine, the belly, and sweating. And, if they
have spontaneously been determined towards the stomach, they may
be evacuated by emetics, but otherwise you must not produce an
unnatural irritation. Such things ought also to be selected as will
eflfect the afore-mentioned evacuations without heating or drying,
such as the juice of ptisan, honied water, oxjTnel, apomel, and the
root of parsley. When the belly is not evacuated, an injection of
mulse, with oil, may be given. The body is not to be rarefied before
evacuations ; but, after evacuations, it may be rarefied by means of
an oil possessing a gentle heat, such as that of camomile. At this
season, all the secretions are promoted by drinking of some watery
wine, and using a tepid bath of sweet water. When the strength
of the fever is an objection, you must neither use wine, the bath,
nor rarefying unctions ; but, in such cases, drinking of cold water
is the most suitable remedy, if nothing prevent the use of it like-
wise. But if all the powers are strong, the fever of a very hot
nature, with clear symptoms of concoction, cold water may be given
boldly. But if he is muscular, and the constitution of the air hot
and dry, he will not be hurt by being thrown into a cold bath.
And if the fever is moderate, and the strength good, with symp-
toms of concoction, baths, the drinking of wine, and unctions of a
rarefying nature will be beneficial to such persons.
XIX. — The Diagnosis of Tertian Fevers.
The tertian fever being occasioned by yellow bile, which is set
in agitation, has a considerable rigor in the beginning, which dif-
fers, however, from the rigor of a quartan in this, that the whole
skin feels as if it were pierced and wounded ; but, in quartans, the
attack is accompanied with a strong chill ; and quotidians have no
preceding rigor, they are only accompanied with a chill. But in
tertians, the order of the pulse is regular, and the fever is attended
with strong thirst towards the acme, and burns up the man ; but,
afterwards, the acme takes place, and the heat is equally diffused
every where. If you apply your hand, at first it is met by a strong
and pungent heat, which seems as if carried upwards in the form
ef vapour, but it is soon extinguished under the hand, if it is al-
lowed to remain. And when the person drinks, straightway a hot
vapour in great quantity issues from the skin, announcing a sweat.
But vomiting of bile supervenes, or the belly is loosened, and they
j:ass bilious urine. With these the fever goes off, having compre-
BOOK SECOND. 149
hended not more than twelve hours in one paroxysm. "When,
therefore, it abates within twelve hoars, we call it true tertian ;
when the paroxysm is more protracted, we name it simply tertian ;
and when the paroxysm is prolonged to the utmost, so as to have
but a small interval, we call it prolonged tertian.
XX. — On the Cure of Tertian Fever,
In the true tertian, as being occasioned by yellow bile, we must
dilute and cool, evacuate the defluxions upon the stomach by eme-
tics, and downwards by the belly, and carry them off by urine and
perspiration. The belly, therefore, is to be moved by emollient
clysters, and the secretion of urine promoted by infusions of parsley
aad dill in the drinks. And if symptoms of concoction appear, you
may confidently give wormwood. Apply also baths of warm com-
mon water, and let neither nitre, nor salts, nor mustard be rubbed
upon his body; but let the patient enter them after having had
warm oil poured over his body. There will be no mistake if those
who are fond of baths be bathed twice ; and, if symptoms of the disease
being concocted appear, there will be no harm even if he is bathed
oftener. Until the disease is concocted, wine is to be entirely pro-
hibited ; but when concoction commences, first some thin and watery
wine may be given, and food of a diluent and cooling nature will be
proper ; but honey, mustard, pickles, and every thing heating must
be abstained from. Such was the practice of the ancients ; nor is
it to be wondered at, as these men were more habituated to exer-
cises and a restricted diet ; but now, when order is perverted, the
bile is, for the most part, found mixed with phlegm. Wherefore,
now-a-days, most tertians are either without a rigor, or it is very
slight.* And the mode of cure is also changed ; for, neither does
the bath suit with tertians now before concoction, nor yet a full diet,
except crumbs of bread, eggs, or the like.
XXI. — The Cure of Spurious Tertians.
It does not suit with spurious tertians to bathe at the commence-
ment, nor until symptoms of concoction have made their appearance.
Neither does it answer to give food every day, but every alternate
day will be sufficient. Rest and warm applications to the hypo-
chondriac region agree with them, also broths of easy digestion,
and clysters not very emollient. And if detraction of blood be ex-
pedient, it ought by no means to be omitted. The nature of the
diet ought not upon the whole to be cooling and diluent, but things
of an incisive nature ought to be added. They are particularly be-
nefited by the juice of ptisan, to which have been added pepper,
hyssop, sweet marjoram, and spikenard. Also, add pepper to honied
water, boil, and g^ve it to drink, and likewise every thing which
will promote the secretion of urine, except those things which are
150 PAULUa ^GINETA.
of a very heating and desiccant nature. In particular, after the
seventh day, give wormwood; and many have been benefited by
drinking oxymel, and taking gentle laxatives. A vomit taken with
food answers well with those in whom the affection is chronic.
XXII. — The Diagnosis of Quartans.
The quartan makes its attack with much coldness, as having its
origin from a cold humour, namely, the black bile ; but it is not
attended with ardour and febrile heat like the tertian, neither does
a vomiting of bile . accompany. If, in addition to these, the urine
be thin, white, and watery, the fever certainly is a quartan ; but the
characteristic of a true quartan is a small and rare pulse. They
have their beginning most frequently in autumn, supervening upon
wandering fevers. At that season, intermittents generally assume
the quartan type, although sometimes the paroxysm observes a
longer interval of days.
XXIW.— The Cure of Quartans.
Those affected with quartans are to be treated gently, without
any powerful medicine or evacuation, unless a great fulness of blood
prevail, in which case it may be necessary to bleed. The diet
should be good and not flatulent, and the belly ought to be loosened
by the customary things ; and, if these are not sufficient, clysters may
be used, at first emollient, and afterwards acrid. They must be
prohibited from swine's flesh, and every thing that is viscid and
slowly evacuated, and also from all cooling and diluent articles of
food. Let them use a thin white wine moderatdy wann, also
pickles and mustard. And after an interval of some days, they
should take the composition consisting of three peppers, or that
called Diospoliticus. And if they take every day of pepper alone in
water, they will do well. But if the patient is at the acme of the
complaint, his diet ought to be very light, he should be enjoined to
take protracted rest, and to take care of his bowels by using emol-
lient and laxative things. Next, let him use diuretics ; and if the
symptoms of concoction appear manifest, then he may boldly have
recourse to such as evacuate black humours, and that not once only,
but frequently. Give him also the medicine from vipers, and such
others as are recommended for these fevers, among which is the
well-known and celebrated one containing the Cyrenaic juice.
XXIV. — The Diagnosis of the Quotidian.
The quotidian does not make its attack with a rigor on the first
day, but in progress of time, a chill rather than rigor takes place,
which is, with difficulty, succeeded by heat, and it goes on long in-
BOOK SECOND. 151
creasing. Yet, it does not make those affected hot, nor their respir-
ation frequent and thick, nor does it make them pant or drink cold
water. But they have vomitings of phlegm, and whatever is voided
by the belly, is cold, crude, and watery, in these fevers. And they
have no sweats during the first days, neither have they an intervd
of freedom from fever. Their colour is white and pale ; their urine
thin and white, or thick, turbid, and red.
XXV.— 7%e Cure of Quotidians.
In curing the quotidians, we use oxymel during the first days,
and those things which promote the discharge of urine. And, upon
the whole, the diet ought to be incisive ; but, at its acme, we must
look to the stomach, particularly its orifice. We must also prescribe
an emetic from radishes with food, and phlegmagogue cathartics
in abundance, until it subside.
XXVI. — On the Fever HepiahiSy and the Rigor tvithoul heat.
Thb vitreous phlegm being the coldest of all, if it accumulate in
the body« and remain free from putrefaction, it occasions the rigor
without heat, which is not attended with fever. In those fevers
which are kindled by the humours, it is putrefaction for the most
part which kindles febrile heat. If it become putrid, and that
through its whole substance, which is rarely the case, owing to its
great coldness, it occasions quotidian fever. But when it is half
putrid, and not equally through its whole substance, but some parts
of it being putrid, and others not, it gives rise to the fever called
Hepialus, in which those affected have rigors and fever at the same
time ; for the parts of the humour which are not putrid being scat-
tered through the veins all over the body, occasion rigor ; but the
putrid parts kindle fever. The word Hepialus is either derived
from ^irtoff cikos, I. e. the sea, which is mDd in appearance, al-
though formidable in reality ; or from ^uds aXcafciv, i. e. warming
gently. And, as this fever is of the quotidian kind, being formed
by phlegm, it is to be treated in particular in the same manner ;
only that it requires remedies as much hotter and more incisive than
the quotidian, as its phlegm is colder than that of the other. The
rigor without heat stands in need of heating things still more than
the hepialus. Wherefore, the composition of thiee peppers, that
from calamint, and still more that from Cyrenaic juice are particu-
larly suitable to this complaint, as also the remedies prepared from
castor and the like. You will find a fuller account of these matters
in the 45th chapter, " on immoderate rigor and cold." The fevers
called Lipyrise, and the Typhoid or smoky, and whatever others arc
mentioned besides those described, being all of the same kind as the
above-mentioned, will require the same methods of cure as those
^bich have been mentioned, or will soon be described.
152 1»AULUS iEOINETA.
XXVII. — On the Continual Fevers,
The continual fevers are allied to each of the intermittents ; thus,
to the true tertian is allied the Causus or ardent fever ; to the quo-
tidian, that fever which has a paroxysm every day, hut does not
terminate in a complete freedom from fever ; and, in like manner,
to the quartan, that which has an exacerbation every fourth day.
For, the true causus has all the other characteristics of the tertian,
and differs from it only in not commencing with a rigor, nor ending
in a complete remission of the fever. The continual fever which
has an exacerbation every day, possesses all the other characteris-
tics of a quotidian, except that it does not terminate in a perfect
apyrexy. In like manner, the continual fever which has an exacer-
bation every fourth day, but does not terminate in a complete apy«
rexy, is allied to the quartan. A continual fever, therefore, is one
which does not terminate in any interval from fever until it is alto-
gether resolved. But when it evinces no remission, it is, indeed,
of the same class as the ardent fevers, but differs from them in
Hcutenesa.
XXVIII. — The Diagnosis and Cure of Synochous Fevers,
Synochous fevers are produced either by effervescence of the
blood, or putrefaction of the same, arising from obstruction, and
have, therefore, but one paroxysm from beginning to end. The
s3niiptoms are, pulse great, strong, quick, dense, equable ; but they
are not pungent ; and the urine is little different from the natural *
The cure of them consists in blood-letting ad deliquium. And those
who are affected with these fevers, and are not bled, run the most
imminent danger. But if any thing should prevent us from having
recourse to phlebotomy, we must use such other remedies as are
calculated to remove obstructions, those which evacuate, and such
as will allay the effervescence of the blood. But when in these
cases you remark symptoms of concoction of the humours, and
there is neither inflammation, sedematous swelling, nor scirrhus in
any important part, nor any part cold, so as that the evil may be
determined to it, you may boldly give cold water, more especially
if the patient has been accustomed to cold drink.
XXIX. — On the Diagnosis of Ardent Fevers,
The following symptoms accompany ardent fevers ; tongue dry,
rough, and black, griping of the stomach, excrements pale, strong
thirst, watchfulness, and sometimes delirium.
BOOK 8BCOND. 153
XXX.— The Cure of Ardent Fevers.
EiTHBR of the following things must take place, that this fever
may terminate completely ; the bilious humonrs most either be eva-
coated or extingaished. They are evacoated then by sweating,
vomiting, or purging downwards; but they are extinguished by
cold drink, with which we have entirely cured ardent fevers. For
diet, those in causns should not take water alone, nor mead alone,
but boiled mead much diluted with water ; for their food ought to
consist entirely of drinks. The bath will suit with those only af*
fected with causns who are free from all inflammatory and erysipe-
latous swelling. And if they exhibit symptoms of concoction, it
will suit still better with them ; but not so if the fever be occasioned
by a saltish humour. These should be supported with the juice of
ptisan.
XXXI . — Diagnosis and Cure of Fevers with an Erysipelatous
affection.
Fbvsrs accompanied with an erysipelatous aflection about the
viscera, may be known by the vehement effervescence and strong
pain in the part, also, by the thirst and inordinate burning ; in a
li^ord, by the S3anptoms of bitter bile putrefying along with a defi-
cient blood. They are to be treated in this manner : the patient
must abstain altogether from the bath, and at the acme of the com-
plaint, use the very coldest water. But it must not be used at the
commencement, but cold things are to be applied externally ; and
if this is not sufficient, they must be taken internally. Lettuces and
«uch like things are particularly befitting. The juice of the lettuce
is likewise a seasonable application externally, also, that of the
boose-leek (seny^er'^vivumj, and such like cooling things. We may
use the following application, which is an excellent one : Squeezing
out the juice of some cooling thing, we put it into a mortar with
purslain, then pound and strain it ; at the time of using, we mix
a little polenta with it, and place it in cold water to cool it. A
piece of cloth folded double is to be put into it, and afterwards ap-
plied to the hypochondrium, and not suffered to remain, but another
cold one must be substituted. We sometimes mix the oil of unripe
olives.
XXXII. — Diagnosis of Hectic Fevers.
The hectic fever is not only seated in the fluids and spirits, but
ftlso in the solid parts. It is unaccompanied with pain, and those
affected with this fever, imagine that they have no fever at all, for
they ars sensible of bo heat, all the parts being heated equally.
154 PAULUa a2:GIN£TA.
Hectic fevers have a double origin, for the most part supervening
upon ardent fevers which have been protracted so long as to con-
sume in time all the juices in the body of the heart ; or they may
come on while these still remain. The former constitute not only
hectic but marasmus. Those that come on while the juices of the
heart remain, seize upon the body of the heart, and hence the fe-
brile flame is kindled, like the flame of a lamp from its wick. This
is one of the modes of formation. The other mode is, when they
make their attack originally, commencing like ephemeral fevers,
from grief, anger, or much fatigue attended with heat. These may
be cured without difficulty ; but those of them which have termi-
nated in marasmus, it is impossible to cure. A hectic fever which
is running into marasmus may be easily recognised. You may see
the patients' eyes immeasurably hollow, turbid, dry, and aflected
with a certain squalid appearance. The vital bloom of their colour
is gone ; their forehead is parched and stretched ; they constantly
wink as if asleep, and yet the affection is not sleep, but an inability to
keep awake ; their temples are collapsed ; and what remains, but the
bones and skin alone? Tf you lay bare, and examine the parts about
the belly, you will fancy that none of the entrails and intestines re-
main, and that the hypochondrium is forcibly drawn upwards. The
skin is parched in the last extreme, the pulse slender, dense, and
hard. The heat on the first application of the hand seema faint,
but soon afterwards feels acrid and pungent. While, therefore, any
of the natural moisture remains, the fever is only hectic ; but when
the humidity runs the risk of being altogether consumed, a true
marasmus is formed.
XXXIII.— 7%e Cure of Hectic Fevers.
Thosb aflbcted with hectic fevers, should be well supplied with
food from the commencement, on account of the pungency of the
humours. The best nure is a moistening diet. You ought also
to give for nourishment, the juice of ptisan, and broths of chond-
rus, adding a little bread ; and to treat the patient with a draught
of moderately cold water, when neither inflammation nor putre-
faction of the humours is present. But if you conclude that the
lesion is great, you must proscribe the cold water, and have re-
course to the cold applications externally. To those aflfected in
this manner, baths are at all times proper.
XXXIV. — On Semi'tertians.
As a tertian paroxysm' commences with a rigor, and a quotidian
without one, the fever composed of both, brings on a degree of
shivering, which is less than a rigor, and greater than chUlness, as
being a combination of these two extremes. Whence, this fever
has not iminroperly got the name of semi-tertian. These fevers are
BOOK SECOND. 155
formed in two ways, either the two paroxysms aniting into one
period, or being mixed together from the commencement. When»
therefore, the tertian prevails, the fever is attended with a strong
shivering, and has even a certain degree of rigor at the attack.
Snch a fever also, soon becomes hotter and more ardent, and brings
on some vomiting of bile, or a discharge of it downwards, or a
sweat. When tiie other, the pituitoos, prevails, there is cold-
ness of the extremities, but little shivering ; neither are they ac-
companied with thirst, nor are they ardent. But when the ter-
tian intermittent and continual quotidian are equal in magnitude,
the commencement of the paroxysm is with shivering ; and when
that from phlegm prevails, there are contractions and shiverings ;
but, if the hotter species prevail, they soon acquire heat. This
is the true semi- tertian, being a fever formed from an equal com-
bination of both, a tertian intermittent, and a continual quotidian.
But that which is not the true semi-tertian, has either more of
the bilious, or of the pituitous character; which species is of
easiest cure, the smaller humour being readily overcome by the
prevalence of the greater, or by the aid of art. When the pitui-
tous state prevails, we must use the remedies mentioned for the
quotidian ; or, if yellow bile, those for the tertian, always bestow-
ing most attention upon that which is most urgent, but not neglect-
ing the other entirely.
XXXV. — On Epidemic Diseases.
Wb call those diseases Epidemic and Common, that attack many
together; which, having a common origin, have also a common
cause. Common diseases are produced by common food of a bad
quality, drinking of bad water, inordinate fatigue, the want of the
customary exercise, deprivation or repletion from the prevalence
either of a famine or of great abundance. The nature of the country
will also often occasion common diseases, either from its l3dng ad-
jacent to marshes, or to some deep pit, which emits a deleterious and
pCTnicious exhalation. These things happen frequently. But the
atmosphere which surrounds us may alter the temperaments, by
being hotter, colder, or more humid than ordinary. For, to other
causes we are not all exposed together, nor do we come in contact
with them for the whole day. But the ambient air is diffused
around all, and is inhaled by respiration. Now, the bodies of ani-
mals must undergo a change along with the differences of tempera-
ture. He, therefore, who is acquainted with these matters, will not
only be able to predict the diseases which are to arise from every
state of the atmosphere, but will be able also to prevent them by
substituting a counteracting regimen to the intemperament of the
air. Wherefore, those bodies which are disposed to a certain
disease, from a natural intemperament, will be affected by a similar
temperature of the surrounding air. But those of an opposite tem-
perament to the atmosphere, instead of being hurt, will be improved;
156 PAULUS iEGINBTA.
the excess of their intemperament being overcome by the opposite
excess. He that is acquainted with these things will preserve the
health, by substituting the contraries to the constitution of the body ;
sometimes perhaps using refrigerants, and sometimes heating things,
cooling with water, using restricted exercise and food, and plenty
of dilution ; and warming, by means of increased clothing, exercise;
more food, and less drink. And, by kindling a great pile, one may
change the air from a humid state to that which is dry and hot, as
they say was done by Acron of Agrigentum.
XXXVl. — On the Plague ^ from the Works of Ruffus.
In the plague there is every thing which is dreadful, and no-
thing of this kind is wanting as in other diseases. For there are
delirium, vomitings of bile, distension of the h3rpochondrium, pains,
much sweatings, cold of the extremities, bilious diarrhoeas, which
are thin and flatulent ; the urine watery, thin, bilious, black, having'
bad sediments, and the substances floating on it most unfavourable ;
tickling of blood from the nose, heat in the chest, tongue parched,
thirst, restlessness, insomnolency, strong convulsions, and many other
things which are unfavourable. Should a person foresee that the
plague is coming, by attending to the badness of the season, and the
unhealthy occupations of the inhabitants, and from observing other
animals perishing ; when one observes these things, let him also ob-
serve this — what is the character of the present season, and what
that of the whole year, for you will be able thereby to find out the
best regimen ; such, for example, as if the temperature of the season
ought to have been dry, but has become humid; in that case, it will
be necessary, by a drying diet, to consume the superabundant moisture.
Care also must be had of the belly, and when there is phlegm in the
stomach it must be evacuated by emetics. And when a fulness of
blood prevails, a vein should be opened. Purgings also by urine,
and otherwise by the whole body, are proper. But, if the patient is
afiected with ardent fever, and has a fiery heat about the breast, it
will not be improper to apply cold things to the breast, and to give
cold drink, but not in small quantity, for it will only make the flame
bum more ; but in full draughts, so as to extinguish it. But, if an
ardent fever prevails within, but the extremities are cold, and the
skin cold, the hypochondrium distended, and the stomach sends the
matters which have been melted, some upwards, and others down-
wards ; if watchfulness, delirium, and roughness of the tongue, are
present ; in these cases, calefacient remedies are wanted, to diflfuse
the heat all over the body, and every other means ought to be tried,
in order to determine the heat from the internal to the external
parts. The following propoma may be used ; — of aloes, two-parts,
of ammoniac perfume, two parts, of myrrh, one part ; pound these in
fragrant wine, and give every day to the quantity of half a cyathus
( 5v). I never knew a person, says Rufliis, who did not recover from
the plague after this draught. So says Rufitis. But Galen says
BOOK SECOND. 15/
concerning pestilential putrefactions, that to drink Armenian bole,
and, in like manner, the theriac from vipers, is of great service ; and
that, in the plague which prevailed in Rome, all died who were not
benefited by either of these things.
XXXVII, — On the Treatment of those who are seized tvith
Syncope from Crude Humours.
SoMB are seized with fever while having a great collection of
crude humours, and while the mouth of the stomach is disordered.
In them the hypochondrium is distended with flatulence, the orifice
of the stomach is more swelled than natural ; in some the complexion
is more turned white and watery, and in others black. None of
these can bear the loss of blood without the most imminent danger ;
but they require evacuation, although they cannot endure phleboto-
my or purging, for even without them they are disposed to fall into
a state of syncope. They are to be cured, then, by friction. It will
be proper, then, at the commencement of the disease, to begin with
rubbing the limbs from above, downwards, with moderately rough
linen cloths, and afterwards, the whole arms from above, downwards.
But when the limbs have been sufficiently warmed, and there ia
danger of a sense of lassitude, we must use a relaxing oil, but avoid
all astringents. When it is winter, we must also use a sudorific one,
such as the Sicyonian oil, or that of camomile. After rubbing the
limbs freely, we must next rub off the oil, and proceed to the spine,
which we must rub in like manner, and then return to the legs, and
from them to the arms again, and afterwards to the spine again, con-
tinuing this practice for a whole day. Honied water, in which hys-
sop has been boiled, is most beneficial in these cases. And they
must neither get solid food, nor soup, nor water, nor be permitted at
all to drink freely ; but they ought to be contented with honied wa-
ter alone for the first three days, and be rubbed in succession. If
the strength be moderately good, and the contents of the stomach do
not pass properly downwards, you may venture with a clyster. But
if there is a greater overflow of the superfluities than proper upon
the stomach, you must first boil the honied water well, for thus it
will be less laxative ; but when the belly is looser than proper, you
must not thus stop it, but, instead of the honied water, give the
juice of ptisan. But if the discharge still continue, we must support
with a gruel made from chondrus. But if we ascertain from the
pulse that the powers of the system are prostrated, it will be proper
to give bread out of diluted wine, provided there be no inflammation
of the stomach or liver. But should they be inflamed at the same
time that the body is loaded with crude humours, the state of the
patient is hopeless. If you perceive that the humours are thick, give
oxymel always instead of honied water ; or, if it is summer, the pa-
tient hot, and fond of cold drink, give him cold oxymel ; but when
in winter, it must be hot. Baths are most prejudicial to such per-
sons. If, when you are called, syncope has already come on, and
158 PAULUS JBQIN£TA.
the parts which I have mentioned are free from inflammation, give
a small bit of bread out of wine, and proceed straightway to the
friction in the manner I have described. In those cases in which
the syncope is occasioned by yellow bile infesting the mouth of the
stomach, we must give cold chink, and administer wine that is thin,
of a bright yellow colour, and old.
XXXVIII. — On t/wae who have /alien into Syncope from thin
Humours.
Those who have fallen into a state of syncope from thin humours,
must be treated quite oppositely to the manner described, for you
will find the diagnostic symptoms quite different. They must be
supported by taking a little food frequently. And their case is to
be thought hopeless when the liver or stomach is inflamed at the
same time that the powers are gone. In these afiections, the ex«
pression of the countenance speedily becomes death-like. It is ne-
cessary to support their strength with food, but their skin must be
condensed instead of being rarefied as in the former case. The air
must be cooled, and they must be rubbed with astringent oint-
ments. They must be furnished with food not very laxative, also
bread and g^els from chondrus, with autumnal fruits that are
austere, and not apt to spoil ; these, either by themselves or with
bread. A watery wine taken from the beginning with the food will
be beneficial.
XXXIX. — On the other causes which occasion Syncope.
Thkrk are four other causes from which men fall into syncope ;
namely, violent pain, watchfulness, too great evacuation, and some-
times motion when in a state of delirium. To these, if you please,
you may add a fifth, namely, an intemperament of the primary or-
gans. Death takes place most quickly when the heart is aflfected,
next, when the brain, but not so when the liver.
XL. — On Pain.
A TORPID pain is occasioned by a cold aflection ; the pulsatory is
characteristic of a strong inflammation. But, if a jierson feel as if
pierced by a sharp-pointed instrument, or bored by a wimble, this
kind of pain is from the thick intestine, i. e, the colon. The pungent
is seated in the membranes. The darting pain attends the most ve-
hement attacks, not only of hemicrania, but also of cephalsea. It
is said to be darting when commencing in the seat of the affection,
as from a root, it spreads quickly to the surrounding parts. Dis-
tending pains take place in the nerves, when they are aflected and
stretched towards both extremities, but they are not liable to be
BOOK SECOND. 169
afS&cted with lateral distensions. The membrane under the skin
when distended occasions tensive and torpid pains ; those between
the flesh, as it were, divellent. For they are many, have irregular
insertions, and surround the flesh. But the pains proceeding from
the membranes which surround the bone, are deep-seated, and seem
to proceed from the bones themselves. Wherefore, when no external
caase of the pain is apparent, you must consider the patient's preced-
ing regimen. If it has been more inactive than usual, or if he has
been taking more nutritive food than common, or if any evacuation has
been suppressed, — if any or all of these circumstances be observed,
plethora is the cause of the pain, and you must evacuate him as
quickly as possible ; for, by this means, you will be enabled with all
safety to use such remedies as are fitted to repel the defluxions from
the aflSscted parts. If the part be distended with a fullness of blood,
open a large vein near it immediately ; but when crudities alone
are the cause, you must purge ; and, when both meet together, you
mast use both evacuations, beginning with the bleeding. If, after
both these remedies have been tried, the pain continue, it is clear
that the ofiending matter has become fixed in the part afiected ; and
it is also clear, that the cure will be accomplished by discutient reme-
dies. In like manner, we may cure pains from flatulence, by sooth-
ing them with attenuant food and injections, and opening the pores
of the part with cataplasms, irrigations, and fomentations. If a
swelling bearing down and pressing upon the part be the cause of
the pain, it must be removed ; but, if it proceed from a pungent
humour, attenuant and calefacient things are most improper. Dill
boiled in oil is anodyne and soporific, and the green more than
the drv.
XLI. — On CoUiquaiive Diarrhoea or Melting.
Whkn any thing is discharged from the bowels which was not
part of the food or drink that was taken, but of the fluids of the body
which had flowed to them, (resembling the yellow bile which is con>
tinually discharged by vomiting and purging, but differing from it
infoetor ; and in this, that the alvine discharge is of a darker yellow,
of the consistence of the sordes balneorum, oily, and adipose) the
disease is called colliquation or melting. At first, the fat and newly-
made flesh are dissolved and melted by the heat of the fever, but
as the evil is protracted, the solid parts themselves are melted down.
In this most unfavourable state of fever, a draught of cold water from
the coolest fountain is the most proper remedy. Likewise, cold
cataplasms and epithems ought to be applied to the chest and hypo-
chondriac regions, and cooling food g^ven.
XLII. — On Watchfulness in Fevers.
Tbosk who are much troubled with insomnolency, we are to
160 * PAULUS ifiQINETA.
direct to have their legs and hands bound with ligatures at the time
when they were accustomed to go to rest ; and make them keep
their eyelids open, or wink, until they are sufficiently fatigued ;
then we suddenly loosen the ligatures, remove the lamp, and order
complete stillness to be preserved. But, when the insomnolency is
obstinate, we must bathe the forehead during the decline of the pa-
roxysm, with the decoction of the heads of the black poppy, and direct
the patient to snuff up the dried and powdered husk of the white
poppy ; or from the root of the mandragora pounded with wine, or
rose oil, we make an emollient ointment (malagma), and rub the
forehead with it. Or, we use, during the paroxyms, wild thyme
boiled in must with melilot. Or, taking the pounded heads of
poppies, we make a cataplasm of it with bread and rose oil, or ce-
rate. And the greatest attention ought to be paid to the food. Let
about three spoonfuls of the seeds of the wlute poppy be added to
the patient's gruels ; and let his pot-herbs be prepared by adding
to them as many of the leaves of the black poppy, if green, as can
be contained within three fingers ; or, otherwise, three or four
dried heads may be boiled with them and taken. If, even by these
means, sleep cannot be procured, let him be smeared with the juice
of poppy or of mandragora. But the electuary composed from the
heads of poppies, and, particularly that which is drunk with sodden
wine, to the amount of a spoonful, or a spoonful and a half, disposes
to sleep. Those who are not troubled with fullness of the head
may use the following fumigations in the decline : — Of Indian Leaf,
of amomum, of costus, of amabo, of each oz. 1, of the fruit of the
balsam tree 9>. 1, of storax, of ammoniac perfume, of Scythian
bdellium, of the root of the mandragora, and juice of poppy, as
much ; use as a fumigation with C3rpress-wood.
XLIII. — On Cataphora or Somnolency.
Spongb the forehead with oxycrate of the temperature of new
milk ; put tight ligatures round the extremities ; and apply to the
nose strong- smelling things of an incisive quality. In the remis-
sions, apply cupping-instruments between the shoulders along the
spine. Wlien the disease is protracted, errhines must be tried dur-
ing the decline. Let the food consist of such things as have in*
cisive and dividing properties, as recommended by us in our general
directions regarding the health.
XLlV.— On the Cure of Headach in Fevers
When headach proves troublesome in fevers, after the accustomed
evacuations, in the decline of the paroxyms, the head ought to be
anointed, first with the common oil from unripe olives, or with rose
oil, to which some vinegar has been added; which, if it be the sum-
mer season, and the fever of the ardent type, may be used cold ;
BOOK SECOND. Itil
bat, in winter, if the fever be not ardent, it mast be hot or tepid.
In the oil, may be boiled the juice of wild thyme and knot-grass
(pofyffonum) I and in summer, the heads of the poppy, or the
poppy itself may be added, as in winter, a little of the hogs-fennel
may be sabstituted in place of it. When the pain continues in the
forehead, if the open of the head be bare, a poultice may be ap-
plied to it, made oif old barley-meal and knot-grass ; or, in like
ttianner, of bread and roses, or of some myrtle or wild thyme.
Some are rather benefited by an admixture of penny- royal, and
otherA, when the affection was of a hot nature, have rather been
reoiedied, by having flea-wort (psyllium) added to the barley-
floor, or even by this sdbitance alone, when boiled to the con-
ttStenc^ of bird-lime. It mnst be frequently changed. Coriander
with barley-meal may be used in like manner. Aloes with myrrh
are also to be rubbed in, or myrrh and ammoniac in like manner,
and crocomagma. Pulsatory pains are dispelled by rue and mint,
with bread, to which a little rose oil has been added. When* the
paiti does not yield to the afore-mentioned remedies, we must first
cut the hair close by the skin, and then rub some of the oily em-
brocations over it all ; after which, cupping- instruments are to be
applied to the hind-head, and the extremities to be bound with
l^^tares, and chafed. Leeches also are a proper application. But
if a catarrh or defluxion raise the pain in the' head, we must ap-
ply the remedies which will afterwards be described in the pro-
per place. But if exhalations from the stomach have been carried
upwards, and hurt the head, we must attend to them, as will be
mentioned below.
XLV. — On the Care of Stomach Affections,
If the stomach be weak, we must apply strengthening cataplasms
to it, such as those made of dates and wine, and of polenta and
saffiron, and of mastich and aloes ; and use embrocations from worm-
woody the oil of apples, and of mastich, nard, and wine ; and if hot,
we must add cooling things, such as the juices of gourd, lettuce,
ptorslain, night-shade, endive, and unripe grapes. But if the
bowels appear to be inflamed, it will be proper to add to the embro-
cations some of the relaxing medicines, such as oil of camomile
and of privet, the grease of a cock or goose and bdellium, ammo-
niac, or the like ; and to the cataplasms, the seed of parsley and
fenugreek, the flowers of the marshmallows and camomile ; and, in a
word, let the application be a compound of relaxing, attenuant, bit-
ter, and astringent properties.
XLVI. — On Inordinate Chills and Rigors in Fevers.
Whsn rigors are critical, we must not interfere with them, nor
attempt to put an end to the struggle ; and a chill succeeding to a
162 PAULUS .EGINETA.
sweat will readily pass away and give no trouble. But when the
rigor and chills are protracted, and more particularly, if occasioned
by a collection of cold phlegm, we are first to apply ligatures round
the limbs in various ways, and then anoint them with the oil of
camomile, or of privet, or of iris ; or, if a stronger application be
required, we may add to the oil some pepper, or the seed of the
rosemary, or adarce, or castor, and the whole body is to be gently
rubbed with these things. And in order that the oil may not run
off, a small quantity of wax may be melted with it. Or, if it is the
rigor not attended with heat, we must use the most powerful re-
storative ointments (acopa), and also, dropaces and sinapisms.
Proper fomentations ought likewise to be got ready. The acrid-
scented things are likewise proper, such as calamint, penny-rojral,
and hyssop. Before the attack, we should likewise give for drink,
honied water, in which pepper and rue have been boiled. And wis
should likewise give of the Cyrenaic juice, to the size of a millet,
two hours before the paroxysm, mixing it up with boiled honey ;
and we are to give the juice of the laser- wort in like manner. And
the composition for quartans, made from the Cyrenaic juice, has
proved beneficial to many. And some, by going into a bath of hot
oil, have shaken off obstinate rigors, as Archigenes affirms. But
Galen directs before the attack, to rub the skin with southernwood,
or dried calamint, or the leaves and flowers of flea-bane (conyza),
or with costus, or pellitory, these two last with oil. By these
means, the rigors will nearly or altogether cease.
XLVIL— 0?i Sweats,
Wb must allow critical sweats to go on until they produce the
necessary evacuation, and co-operate by means of moderate heat
and rest, and not wiping away the sweat (for one brings on ano-
ther), by washing the mouth with warm liquids, by warm drinks,
and by sleep. The sweats which occur in the decline of a fever,
are to be treated like the critical. Sudorific remedies are suffi-
ciently treated of in the 48th Chapter of the First Book. But
when the sweats exceed in quantity, they must be wiped oflf, and
the covering of clothes lightened, so as to cool the patient. For,
by exceeding, they occasion lassitude, and often bring on syncope.^
Let, therefore, the covering be light and moistened ; let the air bie,
cooled; and let ventilation be used during sleep. Let the black
myrtle, pounded, be sprinkled on the body, and gall, and the bark of
the pine in like manner. Let amber and polenta, with astringent
wine, be applied to the proper parts ; and let the face be sponged
with oxycrate. Archigenes uses asbestus and the burned lees of
wine in these cases, and for the rigor not succeeded by heat. For
both, he says, when heated, become dry. He also directs to bathe
the middle parts of the body with the juice of plantain, or corian-
der, or purslain, or cabbage, that they may obstruct the passages of
the sweat. In sleep, pieces of cloth smeared with Cimolian earth
BOOK SECOND. 163
«
diisolved in water, are to be applied to the back and chest. And
the whole body should be anointed with the oil of roses, or of ap-
ples, or of lentisk, or of myrtle, or with the cerates ft-om them.
Bat fatty substances are particularly adapted to them ; for, by shut-
ting up the insensible pores, they prevent the passage of the fluid.
It is clear, that dry food and moderately astringent wines are befit-
ting to them ; but much drink should be avoided, and, in particu-
lar, all things of a very liquid nature, and likewise ft-equent wash-
mgs of the mouth. But, if possible, gestation should be taken in a
cold state of the air. The extremities in particular, are to be cooled by
these means. For those sweats which are extorted by spasms and
pains, tight ligatures, or fomentations, are to be applied to the ex-
tremities, and they may be relieved by gently rubbing with woollen
cloths.
XLVIII. — On Cough in Fevers,
Wx must endeavour to remove a cough in fevers, more especially
in such as come on with rigors, for it exasperates the fever when it
is subsiding. We must give lozenges from boiled honey to hold
below the tongue, for these melt and remove the substances which
obstruct respiration. The time for using them is at the acme of the
paroxysm, and a short time before the attack. Well-boiled hydro-
mel must likewise be given. When there is no suspicion of the
nerves being affected, in process of time you may give oxymel with
confidence, or if not it, the decoction of hyssop, which is a remedy
also for rigors. If the fever is not of the ardent kind, you may
give castor, which is also of use to the nervous system. Electua-
ries may be used, made of the kernels of the common and wild pine,
ins, liniseed, bitter almonds, and nettle-seed. But the most of these
niay be mixed with the food. Turpentine-rosin should be given in
an egg. To the chest and the parts about the trachea, apply a sul-
phurated woollen cloth, and oil of rue, or of iris, or of dill. Tight
ligatures long applied, are excellent for stopping cough, I mean to
the middle and extremities. Nor will it be unsuitable to use staves-
acre dried, which may be chewed with dried grapes or mastich.
The extremities may be rubbed, chafed, and bound with ligatures,
and afterwards the retracted parts unbound. But if the cough an-
noys, owing to the acrid nature of the fever, we must use a gargle
of tepid water. Cold water also is often useful ; and, in like man-
ner, gargles of oxycrate, or of the decoctions of dates, roses, or li-
^Qorice. Moderately cooling things are also to be laid over the
Wels and heart.
XLIX. — On Sneezing.
- Bnxbzing frequently occurring in fevers is troublesome, for it
^ I ^^termines to the head and weakens the strength, and, in some
m2
164 PAULUS iEGINETA.
cases, it produces a discharge of blood. Such are the bad effects
of sneezing, which ought, therefore, to be contended against. It is
restrained by rubbing the nose, forehead, and eyes ; by yawning, fre-
quent friction of the roof of the mouth, eructation, stretching of the
loins, raising the head, turning to the side, gently chafing the ex-
tremities, anointing the masseter muscles, pouring hot oil into the
ears, applying a warm cushion under the chin. It is proper to
avoid being roused suddenly from sleep, and also smoke, dust,
acrid smells, pepper, castor, mustard, and mint. The smell of ap-
ples and polenta is proper, for it blunts the desire of sneezing.
The empty sea- sponges do the same. When there is a ft-equent de-
sire of sneezing without the ability, let the lips be composed, smell
to acrid substances, and let the mind be relaxed.
L. — On Loss of Appetite.
When loss of appetite is occasioned by depraved humours, we
must give those kinds of food and drink, which will either clear
away such humours by vomiting, or downwards by the belly, or
those that by dilution will render them better. You have the ma-
terials of these things treated of in the First Book of this work.
Should the loss of appetite be occasioned by debility, since all debi-
lity is owing to an intemperament of the parts, we must cure the
species of intemperament by its contraries. Wherefore, we will
give a more particular account of loss of appetite in treating of
stomach complaints in the Third Book. But, in fevers, we must
straightway endeavour to bring back the appetite with aromatics,
more particularly by giving polenta pounded in water, or ozycrate,
or diluted wine, or a decoction of some of the fragrant and astrin-
gent ft'uits ; by gentle unction and moderate friction of the whole
body, by chafing, by bathing the face, and swallowing a small
quantity of water. And, by putting the fingers down tibe throat,
the stomach has been roused to bring up the food, more especially
if the fluid discharged be bilious or acid. After the fir&t days, cata-
plasms of dates, of apples, of the wild vine, of wormwood, and of
aloes, ought to be applied over the stomach. Let a variety of sim-
ple food be prepared, and from grain, having some difference from
the common articles, but not very different from those used in fe-
vers ; and among them, those fruits which do not readily turn acid,
nor are very sweet, but are ripe; however, they are not to be eaten
to satiety, but only so as to whet the appetite for other food.
While they are eating, the most delicious articles ought to be pre-
sent, which may have the power to provoke and incite the desire.
After the fever is gone, should the want of appetite continue during*
the recovery, yellow parsnip boiled with oxymel, and lettuces, and.
pickled olives, and capers, and pickles, the bulbi, and every other
stomachic should be thought of; and, in particular, those things
should be recollected in which the patient delighted most when ixx
good health. Walking, gestation, vociferation, calefkcient plasters*
BOOK SECOND. 165
frictions, and exercises, ought to be had recourse to. And drinking
the propoma from wormwood, or from aloes, or swallowing the
vinegar of squills to the amount of a mystrum, have proved excellent
remedies.
LL — On Bulimos or Inordinate Hunger.
If want of appetite should pass into the opposite state, I mean
an excessive atrophy, called bulimos, we must resuscitate such per-
sons with roasted pork, or kids, and other savoury things ; and, in
a word, we must use every strong-scented thing, if the acute stage
of the fever be past. We must bind the extremities, and rouse,
by pinching the cheeks, and pulling the hair and ears. When
recovered, we must give bread that has been dipped in diluted
wine, or any other diffusible thing.
LII. — On the Canine Appetite.
Although this symptom seldom occurs during fevers, it some-
times does afterwards ; and, as it is allied to loss of appetite, as
being the opposite extreme, it will not be improper to treat of in-
ordinate appetite. Since, therefore, this affection is generally oo
casioned by an acid phlegm, we must use those things which will
divide aftd dissipate it. Such, in particular, are all sweet and saline
things, and those which are called heating detergents. We must,
therefore, give largely of the heating wines. Such are the gold-
coloured, and those which are red without being styptic. We must
also give them the sweeter kind, although tiiey should not be
thirsty. When they come to dinner, we must give them first, all
&tty things, and evfery thing beside which is prepared with much
oil, and has no austere or astringent property. These, although
(hey should not overcome the cause of the complaint, at all events,
destroy the insatiable desire of food; but abstinence from them
lessens the collection of phlegm in the stomach. We must also
give pickles, and after them, plenty of the afore-mentioned wines
to be drank. By x>ersevering with these things for some time, the
complaint subsides.
LIIL— 0» Thirst.
A protracted thirst may be supposed to be occasioned by dryness,
or heat of the parts by which liquids pass from the mouth to the
stoinach ; and the natural cure of dryness is sleep, and» of heat,
watching. Some become thirsty from wine, or the heating nature
of their food, in which case, the proper cure is cold drii^. But
some desire drink of a bad quality, as they do food corresponding
to the prevailing cacochymy. I have known persons seized with
166 PAUL.U8 JEGISETA.
unquenchable thirst, of which they died, who had eaten of the
vipers called dipsades, and others who had got drunk upon old
wine ; and also persons on board of a ship, who, when their fresh
water failed them, had drank of sea water, have all died. Febrile
thirst may be mitigated, by pouring upon the head the coldest oil,
or rose oil. But the best remedy for thirst, is the seed of the
black lettuce, chewed, or the liquorice ; or, seed of the cucumber
may be retained in the mouth. Give also the following pill, called
adipson : — of gaVden cucumber, dr. viii. — of tragacanth, dr. iv. —
dissolve the tragacanth in the white of fresh eggs, and when dis-
solved, add to the pounded seeds of the cucumber; and when
softened, form pills, which dry in the shade. Give one of these
pills to hold below the tongue, and drink the fluid of it as it dis-
solves. Give also, to swallow, the decoction of quinces, or of pears,
or of medlars, or of the tendrils of the vine, or the juice of the po-
megranate.
LIV. — On Roughness of the Tongue,
Wk may moisten asperity of the tongue, by making the patients
retain in the mouth a decoction of linseed. But it will be more
efficacious, if sebesten plums be boiled with the Unseed. Having
immersed the finger in this liquor, and rubbed the tongue with it,
let them rinse the mouth with clear water, or let them clean it
with a sponge, and then anoint it with rose oil. And the oil of
roses mixed with honey also answers well. Likewise the juice of
the purslain retained in the mouth, and the sumach used for condi-
ments, when mixed with honied water, have a good effect.
Damascenes, also, and the bones of the sebesten plum retained in
the mouth, and rolled on the tongue, and the stem of the lettuce,
answer well. Archigenes says, that the Indian salt, which, in
colour and consistence, is like the common salt, but which re-
sembles honey in taste, when chewed to the size of a lentil, or, at
most, of a bean, does moisten greatly. They should lie upon the
side (for lying upon the back dries greatly), and they ought to
keep the mouth shut, because keeping it open allows the moisture
to dry up. Sneezing properly produced, moistens the tongue xaore
effectually than any other means.
LV. — On Nausea.
Whbn nausea comes on without being produced artificially, it is
a clear inference that noxious humours are vexing the stomach.
Some feel uneasy, but vomit nothing, the humour being retained
in the coats. When the humours are pituitous, we must g^t them
concocted by rest, spare diet, and sleep. But the thinner may be
ejected by vomiting, produced either with the juice of ptisan, or
with honied water. But those which are viscid and thick, stand in.
BOOK SECOND. 1(>7
need of attcnuant remedies, such as oxymel, and the like. But,
when a noxious fluid is detained in the coats, the powder from aloes,
called Picra, is heneficial, hut astringents are pernicious ; whereas,
if there be much fluid, but not of a noxious kind, astringents will
be beneficial, but the aloetic medicine will bring on marasmus.
When cold is joined to humidity, we must mix calefacients with
astringents. The symptom of the affection being of a cold nature,
is, that there is no thirst, nor sensation of heat.
LVI. — On vomiting of Bile,
To those who vomit bile, a cataplasm must be applied, made of
dates, the rind of pomegranate, and gall, boiled in wine or oxy-
crate, along with pounded bread. And acacia, hypocystis, and the
flowers of the wild pomegranate and sumach, ought to be added to
it. A cupping-instrument, also, when applied with a strong heat, is
of great service. Food ought to be given frequently in small quan-
tities. To those who vomit black bile and have the stomach in-
flated, apply sponges soaked in hot vinegar of the most acrid quali-
ties, or a cataplasm of the leaves of the ivy boiled in wine.
LVII. — On Hiccough.
Singultus is occasioned either by fulness, or emptiness, or the
presence of acrid and pungent humours in the stomach, and when
they are vomited, it ceases. And many, if they only take the medi-
cine composed of the three kinds of pepper, and drink wine imme-
diately after, have hiccough. And it is well known, that many
people hickup when the food spoils on the stomach. Many also
hickup horn, rigors. We will find an emetic a proper remedy in cases
which are occasioned by fulness or pungency, and warmth in those
from cold ; and, when the complamt is occasioned by a plethora of
humours, there is need of strong evacuation. This may be accom-
plished by sneezing, but when emptiness is the cause, sneezing will
not core it ; for in such cases, we must give rue with wine, or nitre
in honied water, orhartwort, or carrot, or cumin, or ginger, or cala-
minty or Celtic nard. These are the remedies for such cases as are
occasioned by corruption of the food, cold, or plethora. When a
redundance of cold and viscid humours is the cause, give castor to
the amount of three oboli to drink in oxycrate, and the same thing
will be of use when applied externally to the skin, along with old
Sicyonian oil. The vinegar of squills or oxymel may also be drank
with advantage. Retaining the breath is likewise of great use.
168 PAUMTS iCGINETA.
LVIII. — On Constipation and Looseness of the Bowels in
Fevers.
Those things which remedy a dry state of the bowels are treated
of in the First Book sufficiently. But since a humid or loose state
of the bowels may prevail in fevers, this also must be treated of ;
for many are cut off not by the fever itself, but by this symptom
alone. In the commencement, we must not interfere with the dis-
charge when it proceeds from corruption of the food and indiges-
tion ; but when the evacuation becomes immoderate, it must be re-
strained. If the discharges are of an acrid nature, that which is
given should consist of good juices, and be otherwise thick, such as
spoon-meats from pearl-spelt (chondrus,) and ptisan. Baths are also
befitting after the complaint has become concocted. But when the
discharges consist of phlegm and are watery* on the other hand,
the food ought to be of a more dry and heating nature, as far as the
fever will permit. Of this kind, are those things which are prepared
from heating condiments. But they must abstain horn baths, un-
less otherwise required. When the digestive faculty is in an atonic
state, we must give food and applications of an astringent nature ;
the food consisting of things in particular, to which pomegranates,
apples, pears, or medlars, have been added, or these fruits them-
selves, and thin fragrant wine of an astringent quality ; and the
applications are to be cataplasms made of polenta, and dates, and
wormwood, roses, myrtles, and such like things. It most be con-
sidered also, to what part these cataplasms are to be applied, I mean
the region of the stomach, the lower belly, or perhaps the loins.
Bloody discharges are restrained and dried up by remedies contain-
ing fine flour of polenta, with frankincense, or manna mixed wttb
wine, or oxy crate. When the watery discharge is acrid, it most
be sweetened by a lavement either with water alone, or the juicQ
of ptisan, or of chondrus, or rice, or tragum, not once, but often;
and afterwards there are to be added dried roses, or myrtleau aa4
sometimes galls ; and an egg with rose oil, and a thin astringent
wine, or the decoction of roses, may be injected or applied to tbsir
anus, which will blunt the desire of going to stooU . But when the
calls are frequent, a clew formed of warm threads may be applied tc^
the anus.
LIX. — On Trickling of Blood and Hemorrhage from tAs Nose.
Since a trickling of blood indicates a fulness in the whole body,
or in the head, being occasioned either by expression or conden-
;^tion, and as a free evacuation would relax them, and diminish
the quantity, it may be proper to evacuate where nature points.
With this view, I have ventured, in cases of quartan epistaxis,
to open the vessels in the nostrils with the reed called Typha.
We must not be contented with a small evacuation, but must take
BOOK SECOND. 169
away blood in proportion to the strength. Spontaneous hemorrhage
from the nose in fevers, when critical, are not to be interfered wiSi ;
but yet, if the flow of blood be immoderate, it ought to be restrained.
In the iirst place, tight ligatures ought to be applied to the patient's
extremities, and his head elevated. It would appear that a ligature
to the privy parts, is particularly adapted for restraining bleeding
from the nose. The nostrils ought not to be wiped, nor the part
irritated, so that a clot of blood may be allowed to form. Let the
nose be cooled by a sponge soaked in oxycrate, and the nostril
plugged vLp with a pledget dipped in some of the astringent appli-
cations. The composition of them, and the rest of the treatment,
we will deliver more fully in the following Book, " on the parts which
are afiected."
LX. — On Deliguium Animi or Swooning.
« Whbn the fainting is occasioned by cholera, diarrhoea, or other
repeated and copious evacuations, we must sprinkle water upon the
patient, twist his nose, rub over the orifice of the stomach, and en-
courage vomiting. We should also irritate the sesophagus with our
:fingers or a feather. Several strong ligatures are likewise to be ap-
plied> when the evacuations are downwards, to the arms ; and,
when upwards, to the legs. The patients are also to be placed in an
easy erect posture, and a cupping-instruxnent applied, so as to pro-
duce revulsion to the opposite part of the body. Wine and water
relieves prostration of strength occasioned by ft-equent evacuatio|is,
provided there be no inflammation of any visceral part, nor violent
headach, nor delirium* nor ardent fever unconcocted, to contra-in-
dicaJte it; for in suc^ casesi wine will do much mischief. And, if it
be summer, and the patient of a hot temperament, and addicted to
drink cold things^ we may give cold drink ; but if the contrary,
warm. When the deliquium is occasioned by profusion of sweats,
we are to constrict the skin, as formerly said, and allow a free current
of cool air. In defluxions on the stomach, none of these things is
fitting, unless the application of strengthening things to the belly
and stomach, and bathing them ; for baths are most beneficial in
cases of stomach defluxions, but greatly aggravate hemorrhages and
sweatings. Those who have fainting fits from plethora, must abstain
from wine, and food, and from baths too, if there be fever. And we
must give them honied water, having thjnne^ marjoram, penny-
royal, or hyssop boiled in it. Oxymel also is beneficial to them.
But if the faintings proceed from depraved humours contained in
the stomach, we must diiect a vomit with water and oil — at the
same time tickling the throat with the finger or a feather. But if
vomiting cannot be thereby procured, we must give pure oil, which
will often evacuate downwards. And wormwood is applicable in
such cases. But if the faintings are occasioned by weakness of the
stomach, we must use tonic medicines, as formerly stated in the
chapter which treats of this aflection, and rub the extremities.
'70 PAULUS itlGINETA.
When they proceed from exposure to immoderate heat, we are to
prescribe the bath ; or, when from excessive cold, we must use the
medicine containing the three peppers, and pepper itself. Those who
fall into fainting fits owing to great heat, or insolation, or from re-
maining long in the bath, may be cured by being sprinkled with
cold water, and exposed to the wind ; by having their stomach rub-
bed, and getting wine and food. But if the swooning be occasioned
by the greatness of the inflammation, or bad nature of the fever in
the attacks, and if the patient is cold, we ought to rub his limbs
strongly, chafe him, apply ligatures, force him to keep awake, and
abstain from food. And these things are to be done previous to the
paroxysm. But those who have fain tings from dryness, two or three
hours before the paroxysm should get for food either the juice of
chondrus, or bread out of water, along with the kernels of the
pomegranate, or apples, or pears. But if great danger be antici-
pated, we must also give wine. Those who have sudden attacks of
fainting are to be thus treated. And in all cases we are to find out
the cause of the deliquiom, and direct our attention to it. And
sometimes the greatest care must be bestowed upon this symptom,
which threatens danger, or death itself.
LXI. — On Ulceration about the Os Sacrum.
This affection occurs most frequently in protracted fevers, owing
to the patients having been long confined to bed. When, therefore,
the part begins to appear red, we make a circular piece of wool,
of the proper magnitude, and lay it below the part, and afterwards
prepare a rose or m}n-tle cerate, containing litharge or ceruse, and
apply it. When there is inflammation, we may use a cataplasm of
bread, with nightshade, or knot-grass, or plaintain, or tender cab-
bage. But if the ulceration be spreading, we are to use a cataplasm
of dried lentils, along with the inner rind of the pomegranate.
COMMENTARY
OK Tax
SECOND BOOK
or
PAULUS iEGINETA.
Ji BE following ancient authorities may be consulted on the subject of
^erer; — Hippocrates, Epidem, et alibi. — Galenus, Comment, in Hippocr,
JEpideniy de Differentiis Fehrium, Meth, Med, lib. viii. Therap, ad Glauc.
lib. i. De Typis, de Criiibus et alibi, — Celsus, lib. iii. — Pseudo-Dioscorides,
jEiuporiit, lib. ii. — Oribasius, Synop. lib. vi. Euporiit. — ^Areteus, Morh,
.Jkcut, ii. 4. — ^Aetius, lib. v. — C. Aurelianus, Fau, Acut, ii. 10. — ^Alexander,
lib. xii. — Alexander Aphrodisieus, Probl.i, 84. — ^Actuarius, Meth. Med. lib.
iii. — Plinius, H. N, xxriii. 66. xxx. 30. — Palladius, de Febribus. — Psellus,
€)ptu Medicum, — Synesius, de Pe6rt6tis.— -Constantinus Africanus, de Febri'
ims, — Serenus Samonicus. — Vindiciani Epistola ap. Fabricii Bibl, Grmc.
torn. xiii. — ^Avicenna, lib. iv. fen .i. — Syrasis Avicenna Expositor, — Haly
Abbas, 'Fheor. viii., Pract, viii. — ^Alsaharavius, Theor. vi., Pract, xxxii. —
Serapion, tr. vi. — Avenzoar, lib. iii. tr. 7. — Averrhoes, Colliget. lib. vii.—
Ilhases, ad Mans, lib. x., ContinenSf lib. xxx.
I. PREFACE TO THE BOOK ON FEVERS.
All the ancient authorities held, that a Fever consists of a preternatural
increase of the innate, or, as it is now called, animal heat. Thus, Palladius
defines a Fever to be ^* a preternatural heat, which begins in the heart, and
is diffused by the arteries over the whole body, sensibly injuring the actions
of the body.'' Hippocrates, Galen, Aetius, Alexander, Psellus, and Actua-
rius, give similar dennitions. Cslius Aureliauus, says of Asclepiades : — ** Fe-
brium ponit signum calorem plurimum.^* — Morb, Acut, i, 14. Isidorus defines
a Fever thus : — ** Febris a fervore dicta est ; est enim abundantia caloris/'
Orig. The celebrated Erasistratus maintained an opinion, lately revived by
Clutterbuck, that Fevers and Inflammations are identical. — (See Milligan s
Celsns, p. 13. and p. 112). He further taught, that in Fevers, the blood of
the veins is thrown into the arteries. Plutarch, de placit, Philos, v. 29.
172 COMMENTARY ON THE SECOND BOOK.
The Arabians adopt the opiDions of Hippocrates and Galen. Thus,
for example, Haly Abbas defines Fever to be a preternatural heat proceed-
ing from the heart, and diffused by the arteries over all parts of the body.
According to him there are three kinds of Fevers. First, those which are
seated in the spirits, and affect only the heat of the body. These are called
£pheraeral Fevers. The Second, originate in a vitiated state of the fluids,
which impart a preternatural degree of heat to the heart, whence it is dif-
fused over all the body. The Third arise in the vital organs and solid parts,
from which heat is transmitted to the heart. Pract, viii 2. — See also, in
particular, Rhases, Cont. lib. Xxx.
That an increase of the temperature of the body is an almpst invariable
concomitant of Fever, was satisfactorily proved by the,thermometrical ex-
periments of Dr. Currie. Medical Reports.
II. OF THE PRINCIPAL CONSIDERATIONS TO BE INQUIRED INTO WITH
REGARD TO FEVERS.
This Chapter, and great part of the Contents of this Book^ are taken from
Galen, Therap, ad Glauc, lib. i. or from Oribasius, Synop$, lib. vi.
III. WHAT TO CALL THE COMMENCEMENT OF THE DISEASE.
The whole of this Chapter is taken from Galen, de dUhus discretoriis,
where the question is fully discussed. Aetius, like our author, defines the
commencement of a Fever, to be the time when the strength of the patient
being overcome by the complaint, he is obliged to take to bed. On this
point, the Arabians venture to differ from the Greeks. Thus, Rhases and
Avicenna reckon the commencement from the time when the patient first
feels a departure from health.
The disagreement among the authorities upon this point is to be regretted,
as it tends to obscure the doctrine of the Critical Days.
IV. HOW TO KNOW WHETHER THE DISEASE WILL PROVE FATAL
OR NOT.
This description of the fatal symptoms of common Fever, will bear a com-
parison even with Pringle*s admirable detail of the unfavourable appearances
of Jail Fever. Our author's description, indeed, is mostly taken from the
Prognostics of Hippocrates, and the Commentary of Galen upon the same.
Galen gives an explanation of the causes of the symptoms, from which we
shall select a few specimens. It is one of the Prognostics of Hippocrates,
that profuse perspiration in acute Fevers is unfavourable; and, in explana-
tion of this, Galen states, that a critical sweat may indeed be favourable ;
but that such as are profuse and continued, indicate a complete prostration
of the vital powers. A fixedness of the eyes, is said, by Hippocrates, to be
a fatal symptom ; the reason of which, according to Galen, is, that it pro-
ceeds from paralysis, or insensibility of the muscles of the eye. Hippo-
crates mentions it as an unfavourable symptom when the patient lies with
bis mouth open; and Galen, with seeming propriety, attributes this symptom
to the origin of the nerves, that is to say, the brain, undergoing pressure.
Hippocrates states, that involuntary discharges from the bowels are an un-
fevourable symptom; and Galen justly remarks, that they indicate' great
insensibility.
COMMBNTART OK THE SECOND BOOK. 173
Celsus fi^ves an elegant translation of this part of the works of Hippo-
crates. The following is his version of the description of the Facies Hip-
pocratica : — *' Ad ultima jam ventum esse testantur, nares acutic, collapsa
tempora, concavi oculi, frigidae languidseque aures et imis partibus lenitar
verse, cutis circa frontem dura et intenta, color aut niger aut perpallidus.**
Other unfavourable symptoms are also strikingly portrayed : — '* Mali morbi
testimonium est vehementer et crebro spirare ; a sexto die cepisse inhorres-
cere; pus exspuere; vix excreare; dolorem habere continuum; difficulter
ferre morbum; jactare brachia et crura; sine voluntate lachrimare; habere
huraorem glutinosum dentibus inhaerentem; cutem circa umbilicum et
pubem macram, prscordia in6ammata, dolentia, dura, tumida, interna, ma^
gisque si hxc dextra parte, quam sinistra est ; periculosissimum tamen est, si
vens quoque ibi vehementer agitantur/'
Aetius and Oribasius, like our author, borrow almost every thing from Hip-
pocrates and Galen.
Rhases and Avicenna, particularly the latter, treat of the prognostics in
Pever very fully. Avicenna, like Hippocrates, sets down deafness as an un-
^vourable symptom. Pringle, on the contrary, states it as rather a fa-
vourable one. On this point, my own experience inclines me to lean to the
side of the ancients. Dr. Russel found deafness an unfavourable symptom
of the Plague at Aleppo, 1760. Hippocrates had stated, that Jaundice com-
ing on before the seventh day, is un&vourable ; but Averrhoes affirms, that
sill the Indian and Persian physicians reckoned it a favourable symptom.
IRhases considers yellowness of the skin an unfavourable symptom, unless
the Fever be of a bilious nature. Alsaharavius says, it is an unfavourable
complication when it does not prove critical. He states it as a dangerou:}
symptom, when the patient lies on his back with his legs drawn up. This
agrees with the Prognostic of Celsus — ^ Mors denuntiatur ubi aeger supinus
cubat, eique genua contracta sunt.'' Avicenna and Averrhoes, state it as a
£ital symptom, when the patient sinks down in bed and exposes his hands
and feet. Averrhoes, Comment, in Cantica Avicenna.
Prosper Alpinus g^ves an admirable account of the Prognostics in diseases.
— See nis work, de prasagiendd morte et vitd agrotantium, passim. He
agrees with the ancients, that deafness is an unfavourable symptom, unless
it occur at the time of a crisis. Like the ancients, he considers the absence
of thirst an unfavourable symptom in ^ardent diseases, as indicating that the
system is insensible of its wants.
y. HOW TO KNOW WHETHER THE DISEASE WILL BE OV LONG
DURATION.
Celsus thus states the Prognostics of a protracted Fever : — '' Signa qu»-
dam sunt, ex quibus coUigere possumus, morbum, etsi non interemerit, lon-
gius tamen tempus habiturum : ubi frigidus sudor inter febres non acutas
circa caput tantum, et cervices oritur : aut ubi, febre non quiescente, corpus
insudat : aut ubi corpus modo frigidum, modo calidum est, et color alius ex
alio fit; aut ubi, quod inter febres aliqua parte abscessit, ad sanitatem non perve-
nit; aut ubi aeger pro spatio parum emacrescit : item si urina modo liquidaet
puraest, modo habet qua^dam subsidentia; si Isevia atque alba rubraque sunt^
qos in e& subsidunt; aut si quasdam quasi miculas reprssentet; aut si bul-
lulas excitat."
Galen has given a full exposition of these symptoms in his Commentary
on the Prognostics of Hippocrates, from which Aetius, Oribasius, and our
author have borrowed largely. Rhases, Avicenna, but most especially Haly
174 COMMBNTART ON THE 8BC0ND BOOK.
Abbas, treat at great length of this subject. See also Averrhoes' Commen-
taries on the Cantica of Avicenna.
VI. HOW TO KNOW WHETHER THE DISEASE WILL TERMINATE BT
A CRISIS OR BT A RESOLUTION.
A SIMILAR Statement is made by Aetius, v. 22. See also Averrhoes, Com-
ment, in Cantica Avicenna.
VII. ON THE CRITICAL DATS.
The father of medicine, who was profoundly skilled in Semeiology, appears
to have attached great importance to the observance of the Critical Days.
At first, as Galen remarks, he seems to have been undecided respecting cer-
tain days, and, accordingly, he gives a somewhat different account of them
in his Prognostics and Aphorisms from what he has done in his Epidemics.
His latter list of Critical Days differs little or nothing from that of Galen. .
Galen reposes such confidence in the doctrine of Critical Days, that he ^
affirms, that, by a proper observance of them, the physician may be able to '
prognosticate the very hour when a Fever will terminate. The following i&
his List: — ^The 7th is particularly favourable; next, the 14th; next to these,
the 9th, 11 U), and 20th ; then, the 17th and 5th ; afterwards, the 4th, 3d, and
18th. The 6th is very doubtful and unfavourable; the 8th and 10th, like the
6th ; the 12th, 16th, and 19th, like the 8th and 10th. Intermediate between
these two lists of Favourable and Unfavourable days, is the 1 3th. He informs
us that Diodes and Archigenes held the 21st to be particularly favourable,
but he agrees with Hippocrates in rejecting it, and adopting the 20th.
Celsus follows the system of Archigenes. He says, '' Kpurifioi dies erant,
dies tertius-quintus, Septimus, nonus, undecimus, quartus-decimus, unus et
vicesimus; ita ut summa potentia septimo, deinde quarto-decimo, deinde
uni et vicesimo daretur.'' But he does not hesitate, afterwards, to express
his distrust in the whole system; for, he adds, ''verum in his quidem anti-
quos tunc celebres Pythagorici numeri fefellerunt; cum hie quoque medi-
cus non numerare dies debeat, sed ipsas accessiones intueri.'^
The Greek writers subsequent to Galen adopt his system, with little or no
alteration. Aetius arranges the Critical Days thus : — First in order, the 7th
and 14th; then, the 9th and 11th; next to them, the 17th and 5th; then, the
4th; and afterwards, the 3d and 20th. The 6th is usually bad.
The Arabians, with scarce one exception, adopt the Galenic system. Avi-
cenna, who treats of the Critical Days very fully, mentions the list of them
given by Hippocrates and Galen, and also that by Archigenes, but decides
in favour of the former.
Rhases mentions the Critical Days in the following terms: — ^The 3d is cri-
tical in very acute fevers ; the 4th is indicative of the 7th and 6th ; the 5th is
favourable; the 6th, generally unfavourable; the 7th is a particularly favour-
able or unfavourable crisis ; the 8th, rarely critical, but, if it be, unfavourable;
the 11th, critical and indicative of the 14th; the 12th, rarely critical, and like
the 8th; the 13th, rarely critical; the 14th, critical and favourable; the 15th,
like the 13th; the 16th, like the 12th; the 17th, like the 9th, and indicative
of the 20th; the 18th, rarely critical, or unfavourable; the 19th, rarely criti-
cal, or, if so, not bad; the 20th, next to the 14th, and favourable; the 21sty
sometimes critical, but less frequently so than the 20th ; the 24th, resembling
the 20th; after these, the 27th, 31st, 37th, and 40th, are critical. Averrhoes
remarks, that great deference is due to Rhases* opinion upon this subject,
C'OMMSNTARY ON THE S£COND UOOK. 175
since it was confirmed by experience, in more than ten thousand cases, in an
Infirmary (in infirmaria Relenson). His list is very little different from that
of Galen. In bis Continensy he gives an account of the systemof Arcbigenes,
but states that he prefers that of Hippocrates. Lib. xxxii.
Averrhoes states, that the medical world was divided between the systems
of Archigenes and Galen, but he inclines to the side of the latter in this case,
although on most occasions given to dispute his authority.
Avenzoar, upon the whole, nearly agrees with Rhases, but expresses him*
self undecided with regard to the 20th and 21st days. His authority must
also be allowed to be bf great weight upon this subject, if we may believe
Averrhoes, that he lived to the age of one hundred and thirty-five, and practised
medicine from his fortieth year.
To the first class of Critical Days, according to Haly Abbas, belong the 7th
and 14th; to the second, the 11th and 20th ; to the third, the 4th, 17th, and
21st; and to the fourth, the 3d, 5th, 9th, and 18th.
Alsaharavius gives a similar list to Haly's. He inclines rather to (he 20th
than the 21st day.
Galen, and most of the ancient authorities, believed that the Critical Day^
are influenced by the moon. Dr. Mead zealously defends this doctrine.
Nihel says, "I dare venture this bold assertion, viz. — that the observations
of the ancients on Crises have never yet been publicly proved false or preca-
rious, or our neglect of them properly justified by any author.*' On the I*ulse,
p. 76. The truly learned and modest Van Swietan, after the fullest investi-
gation of the subject, came to the conclusion, that the ancient doctrines with
regard to the Critical Days are founded on nature and experience. Comment.
§ 587. See an interesting dissertation on the Critical Days in the works of
Bordeu. There is no end to quoting authorities upon both sides of the ques-
tion. Van Helmont is one of the most decided antagonists of the ancient
doctrines; and Castellus, Boerhaave, Hoffman, Forestus, Cleghorn, Stahl,
and the late Dr. Robert Jackson — no mean authority upon any matter relat*
ing to Fever, — maintain the propriety of attending to the Critical Days, and
e^^pouse the opinions of the ancients with regard to them.
Prosper Alpinus gives a correct summary of the ancient doctrines respect-
ing the Critical Days, depra$, vita et morte agrot, vi. 4.
VIII. THAT CRITICAL SYMPTOMS APPEARING IN THE BEGINNING
ARE BAD.
The opinion here delivered is derived originally from Galen, but is
'Maintained also by Oribasius, and the other authorities. It requires no
Comment.
IX. HOW TO JUDGE OF A COMING CRISIS.
This chapter is copied from Oribasius, 5ynop. vi. 3. The subject is fully
^**eated of by Galen, de Crisibus. Rhases describes very accurately the
Symptoms of an approaching crisis, such as, confusion of the understanding,
Vertigo, headach, inquietude, involuntary flow of tears, pain of the stomach,
^c. He warns the inexperienced not be alarmed at the violence of the pre-
cursory symptoms, de Ke Med, x. 26. Avicenna, Averrhoes, Haly Abbas,
^nd Alsaharavius, though they treat of the subject very fully, supply no ori-
ginal views.
See an ample account of the ancient opinions in Prosper Alpinus, rfcpr<f^
^'*ta et morte O'grot. lib. vi.
176 COMMENTARY ON THB SECOND BOOK.
X. HOW TO RECOGNISE A PRESENT CRISIS.
This is taken with very slight alterations from Galen, Therup. ad Glauc.
lib. i. See also, de Cruibus, iii. 2. The critical evacuations enumerated
by Galen are, those by vomiting, by the belly, by urine, by sweats, by
hemorrhage from the nose, by hemorrhoids, by the menses in women, by
abscesses of the parotid glands, and by determination to the knees, feet, or
some other part not vital. He says, there are three ways in which a fever
may terminate favourably, namely, by an evacuation, by an imperfect crisis
without an evacuation, and by resolution, that is to say, when the febrile
symptoms gooff gradually.
There are likewise three unfortunate terminations ; for, the patient may
die suddenly with much agitation, or in consequence of a metastasis, or he
may be slowly wasted by a marasmus.
Averrhoes enumerates the same kinds of critical evacuation as Galen, and
otherwise treats of them very judiciously. CoUiget. iv. 39. Avicenna gives
a long account of all the circumstances attending the Crisis, but he copies
closely from Galen and Hippocrates, lib. iv. fen. 2. tr. 1. Haly Abbas, in
like manner, is sensible ana correct, but borrows from the Greeks, Theor,- x,
10. The account given by Rhases is excellent, but it differs little from our
author's. Ad Mamor. z. 27. In his Continent, he gives a full exposition
of the Galenic doctrines, with his own Commentaries. He states, that a
Crisis may take place in six ways ; by hemorrhage at the nose, by an alvine
evacuation, by vomiting, by a discharge of urine, by a sweat, or by an apos-
teme, Lib. xxxi.
XI. HOW TO DETERMINE WHETHER A PAST CRISIS BE PAVOURABLB.
This requires no Commentary. See, however, more fully Galen and
Rhases, u, $,
XII.-— ON THE PULSES, FROM THE WORKS OF GALEN.
The ancient authorities on the Pulse, are the following : Celsus, iii. 6.
Galenus, Ubellus de puisitnts ad Tirones, de different, pvlsuum, de dignoscen-
dibus pulsibus, de causis pulsuu?n, de prasag. ex puis., Si/nopsis librorum dt
pulsibus. — Philaretus, de pulsu. — Actuarius, Meth. Med. i. 9. — ^Avicenna, lib.
i. fen. 2. doc. 3. — ^Averrhoes, CoUig, iv. 16. — Haly Abbas, Theor, lib. vii.— -
Alsaharavius, Theor. tr. vii. — Rhases, ad Mamor. x. 32. Continens, lib. xxxi.
— Psellus, Opus Medicum apud Boissonade, Anecdota Graca,
Prosper Alpinus, gives an excellent exposition of the ancient doctrines on
the Pulse, de pras. vii. et morte agrot. iv. 3. — Le Clerc's account is not so
accurate. Hist, de la Medic, Wetsch is tolerably correct, de Pidsu,
Hippocrates does not appear to have attached much importance to the
observation of the Pulse, for he generally neglects to mention its characters,
and that even, where we would most expect to find them stated, as, for ex-
ample, when he is detailing the symptoms of Epidemical Fevers. Celsus,
too, expresses himself in doubtful terms respecting the indications (uniished
by the Pulse. — '' Venis enim maxim^ credimus, fallacissimae rei ; quia s«pe
ists leniores, celerioresve sunt, et setate, et sexu, et corporum naturi; et
plerumque satis sano corpore, si stomachus infirmus est, nonnunquam etiam
mcipiente febre, subeunt et quiescunt; ut imbecillus is videri possit, cui
OOmiBNTART ON THB SBCONO BOOK. 177
bdle laCuro gravis Mstat aoccssio. CooUra saepe eas concitat et resolvit sol,
et balneuDiy et eaercitatio, et metus, et ira, et qualibet alius animi afiectut.''
Aretseus and Cselios Aurelianus are indeed sutiScieotly minute and accurate
in detailing tbe characters of the Pulse, while describing the symptoms of
various diseases^ but neither of them has written expressly on the subject;
and, as the works of Ueiophilus and Archigenes are entirely lost, Galen must
be considered as our first and great authority on tlie Pulse — i night almost
have said our sole authority, for all subsequent writers were content lo adopt
his system, without the slightest alteration. As our author's account is pro-
fessedly taken from the elaborate treatises of Galen, it may, perhaps, appear
uuneoessary for me to attempt any further exposition of the system ; but the
importance of the subject, and, I may add, its novelty to modem readers,
have induced me to make some detached observations upon it, in order to
explain some parts of it which are confessedly obscure, and to answer cer-
tain objections which have been stated against it, by modern writers who
have not properly understood its principles.
Van Helmont, although compelled to admit the ingenuity of Galen's sys-
tem, pretends to differ from him respecting the final cause of arterial action
and respiration, which, he maintains, is not refrigeration but the preservation
of animal heat. (Operoj p. 112.) But, if he had read Galen's Work, de
Um Re$pirmtumi$j carefully, he would have found that this is the very sense
which Galen attaches to the terms Refrigeration and Ventilation. Van Hel*
mont states, as a new discovery, that a sort of concoction of the blood takes
place in the left Ventricle of thie Heart. But he might have found this doc-
trine also in the Works of Galen.
The first distinctions of the Pulse are derived from the extent of tbe Dias-
lole, according to its three dimensions, namely, length, breadth, and depth.
These give rise to the characters, longy broad, and deep or high, (he Cierc
renders the last by ElevL) A long Pulse, of course, refers solely to the im-
pression on the finger, as in reality one Pulse cannot properly be said to be
longer than another ; but when a person is lean a larger portion of the artery
can be felt under the finger than when he is fat.
The character deep or high is easily understood, and is evidently produced
by a free dilatation of the artery. It does not indeed appear evident how
there can be a difference between a deep and a hroad Pulse, if the dilatation
of an artery were equal on all sides ; but Galen positively affirms, that it is a
feet ascertained by ample experience, that sometimes there is a free dila-
tation of the artery upwards with a contracted one laterally, constituting a
fiigh and narrow rulae ; and, on tbe other hand, that there is often a free
dilatation laterally with a contracted one upwards, constituting a low and
ifroad Pulse. He gives directions for detecting these peculiarities of the
artery. De Dif. FuU. iii. 2.
The eharacters o£ quick and slow are derived from the length of time occu-
pied in the actions of ssrstole and diastole. They seem to be sufficiently
well marked, and yet Fyens denied that there is any difference between fre^
pauy and quicknisi. However, many of our late authorities in medicine
acknowledge a distinction between these two characters, and they appear to
me sufficiently obvious.
The distinctions of strong and feeble are derived from the force with
which the artery strikes the finger. No one can possibly mistake them.
The relaxation and constriction of the arterial tube give rise to the charac-
ters of soft and hard^ which are so obvious that they cannot be misunder-
stood.
The next class of Pulses derive their characters from the time which elapses
^tween two diastoles or pulsations of the artery. They are called dense and
N
176 COMMBNTABT ON THB SBGOND BOOK.
rarcy in the ancteot system, being uied in the same lense thotyre^aini^ and
tkw are in modern works.
The terms equal and unequal (or^ as they might have been translated,
equabU and unequable)^ arise from the constancy or inconstancy of any pe-
culiar character of the arterial pulsation. The rtgular and irre^Uar arc ois-
tinguished from these, inasmuch as a seiies of pulsations, alth^igh unequal
mar be regnlar, when they observe a certain raUo, as when four strong pul-
sations are succeeded by a feeble one, and this series goes on successiTely.
An inequality may take place in respect to one pulsation ; for, the dilatation
of the artery may be interrupted, and then completed, when it is called dor-
cadiiunUy eaprixafUy or goat-leap; or, the stroke may be suddenly repeated,
when it is called dicrotosj which may be translated the double^ reverbenU*
lag, or rebounding Pulse. The term dorcadissans is derived from dorcas^ an
animal generally supposed to have been the goat, but as Harris, in his Na-
tural History of the Bible, remarks, it was probably the Gaaelle; and, in
the Latin translations of Avicenna and Haly Abbas it is rendered GaMelUmt,
It is said that, when this animal leaps upwards, it at first takes a short
spring, then seems to make a sudden stop, and afterwards takes a much larger
and swifter bound. This character was applied to the pulse when an imper^
iect dilatation of the artery is succeeded by a fuller one. It is thus descrio«i
by Haly Abbas : — ** Gazellans pulsus est qui cum a celeritate indpiat ante-
quam percussiat stat, dehinc velociter movetur : vocatur autera hujusmodi
gazelenus suli ex similitudine caprioli saltu : quum capriolus quern Oazel Ara-
bic^ vocant cum saltum dederit pedes toUit et suspensus pauco videtur ten^
pore atque sic ad terram velociiis redit.*' The translator of Alsaharavins renders
It by Fusalis, It is correctly stated by Fouquet that the second pulsation is ne-
cessarily larger than the first. The Dicrotos consists of two pulsations, follow-
ing npon one another so rapidly as to form, as it were, but one beat of the
artery. In the translation of AUaharavius it is called Maliearu, and is thus
defined : — ** Est autem pulsus mallearis qui percutit manum etr8cedit,deiude
redit et percutit secundario.'' We shall have occasion presently to compare
it with the Pulsus Dicrotos, or Redoubling Pulse, of Solano and Nihell.
When there is a succession of pulsations which diminish in magnitude re-
gularly, such a system of pulses are called Myuri — that is to say, decurtaie
or sharp^ailed, from their supposed resemblance to the tapering tail of a
mouse. Those who are acquainted with the Scholiast on Hephcstion, and
the other ancient writers on Prosody, will readily recognise a term with which
they are familiar. Of these Pulses, some end in complete Asphyxia, and
hence are called swooning, f ailing^ or fainting Myuri (Le Clerc rendera it by
le Myurm dtfaillant); and others again gradually recover their foimer
magnitude, and are called recurrent Mjpwi, Nearly allied to these are the
innucntcs ct circumnuentes, for which it is scarcely possible to find any ap-
propriate term in English. Le Clerc thus renders and explains this pulse,
in French : — ^ Le My urns qui va en baisumt de chte et d^mUre^ €*est a dire
qui frappe moins sensiblement le premier et le dernier doigt que celui on
ceux du milieu.'* It consists, in fact, as Avicenna explains, of a double
Myurus, which swells out in the middle, and diminishes at both extreaiitiee.
The Myurus, and the Innuens et Circumnuens, are thus described hf Hake
Abbas : — *' Est autem et in hac specie unius pulsationis pulsus qui wmru
Cauda appellatur; quique inclinus vocatur pulsus. £t qui muris cauda vo*
catur fit cum arteria dilatatur sub primo digito qui a superioribus est grana,
et sub secundo minus grossa, sub tertio parva, sub quarto minima. Imclimm
autem pulsus est qui sub duobus mediis movetur digitis grossus et sub ex-
tremis nine et inde sobtilis et tenuis ; aut medium ejus elatum est, et extiemi-
tatis demissae, videturque tangenti arterise extrema ad infonora declinari."
Sprengel appears to have thought that the pulsus inclinus of Haly Abbas i
COMMBNTART ON TBI 8BCOND BOOK. 179
one 6ril deteribtd by him, but there can be no doubt of its being identical
with the innuemei eirctimimefu{petmtKmsKaifrtpaf€vevK»f)ofQ9Xen*9 System.
Ib the Spasntodic Pulse, the artery is said to convey the sensation of a string
or cold tigiitly strelehed, which, When touched, starts from its place. It seems
to be the Ptiktu Torlvoiiif of Alsaharavius, and is commonly met with when
oooTokooDS w» impending.
The Vikrmtmy deriTes its name from an imaginary resemblance to the mo-
tions of a rod or dart when thrown into the air, and it can only take place
when the artery is haid^ and the strength good. Le Clerc renders it U pauU
dmrdtmi.
The Vndulaiory derives its name from a supposed resemblance to the roll-
ing of the waves, and can only take place when the arteiy is particularly soft,
being acoompaiiied with an unequal elevation of it in the diastole, it is thus
described by iihases : — ^Undosus veroestqui secundum latitudinem, magnum
digiti occupat locum, cum lenitate et tepletione, cum eo tamen non est mag-
na elevatio neqne subita, sed videtur quod elevationem ejus una post aliam
contingit, donee it ut undis assimilatur, quarum una aliam sequitur." Ije
Clerc rendeis it ontkwant.
■Ob rtrwmmlmliSen from the last-mentioned only in magnitude and
streDgtl^ being soft, small, and weak. Nearly allied to it is the Formtcam
or awl^-lifcgpulBe, which is one of the last degree of weakness, smallness, and
densil|r. They are thus described by Khases : — **^ Verraicolosi forma est ut
forma tmdosi, in elevatione qu« secundum diastolem eadem invenitur, non
tamen est latus, neque plenus, cujus inundatio existit debilis, qui vermibus
per Ibnunen avteris discurrentibus assimulatur : formicans vero pulsus adeo
invenimr in ultimo parvitatis, et spissitudinis consistere, ut pulsui pueri re-
cois nati assimnletur." The Chinese compare the Formicans to a silk
thiead, aeapiilary tube, or a hair.
The luUrmittcnt and Intercurrent pulses are opposed to one another, there
bfing a oamplete £ukire of a pulsation in the one case, and an accessory or
superfluous one in the oth^ . There cannot be a better proof of the imper-
fection in our modem systems of the pulse, than that there should be no men-
tion in them ef the Intercurrent pulse.
The Hectic pulse, it is well known, is small and dense.
The-Sorra^eri is hard, quick, and unequal in its feel. Hhases says that it is
principailj observed in inflammations of tlie Pleura and Diaphragm. Le
Clerc fenders it It pauk -en maniere de »cie. Hi»t. de la l^led. p. iii. l.iii.
c. 3. It appeaiB to correspond with the pulse called harsh in the works of
EagiiBh writ/en on medicine.
Berdea speaks af the terms ^/armiraiu, rm/urus^ and caprizam^ as having
been jnatly bMiished from our modem nomenclatures. But it may be doubted
whether it be faam superior inifbrmation or from ignorance that we have re-
jected theae nice disdnctions. Some of these terms were in use long before
the time of Galen ^he mentions that HerophiUis used the term dorcadUsa'M)^
and ibr mare than a thousand years afterwards the characters of the pulse to
which they were applied vrere acknowledged as real; and, on a matter de-
pending-solely upon experience and observation, the concurring sufTrages of
80 many ages must be admitted to be entitled to some considei'ation. That
maay of the Gteek and Ajrabian physicians were men of great learning, and
<»f nradi fMracticalekill in medicine, cannot admit of a doubt; and therefore the
opinions of such men ought not to be hastily rejected as visionary and un-
fomided. Galen, indeed, expresses in strong terms the difficulty which he
^d in defining accurately the states of the artery to which the terms we are
irvftting of are applied, and warns the reader that such characters are to be
<^t6cted only by a person well experienced in the art of feeling pulses, which
^ pronoonces io be one not easily attained . It is worthy of remark, further,
n2
180 COMMENTARY ON THE SECOND BOOK.
that the truly learned and experienced Prosper Alpinus recognized and de-
scribed these characters of the pulse, De Pr. Vit et Morte .^Igrot,
Whoever will consult Galen s treatises on the Pulse will find discussed in
them many subtle questions which are now seldom thought of. For example,
he enters into a disquisition, whether or not we can perceive the systole of the
artery. He informs us that Agathinus had denied, and Herophilus affirmed,
the possibility of this. He, after having, as he says, exammed the matter
fully, agrees with the latter.
Psellus gives the characters of the Pulses in not inelegant Leonine verses.
The causes which produce all these varieties of pulse, and the changes of
the system which they indicate, are, upon the whole, pretty clearly explained
by our author ; and the reader who wishes to consult other abridgments of
the doctrines of Galen may find them in the works of Rhases, Haly Abbas,
and Actuarius. I shall merely make a few remarks upon some of the more
obscure and least understood parts of the system, and compare it with a
celebrated modem Theory of the Pulse.
Respecting the Myuri, Galen states that they all indicate a prostration of
the vital powers, but differing in degree, according to circumstances. When
the pulse gradually becomes smaller, and in like manner recovers its magni-
tude gradually, and so on alternately, so as to form the Recmrent Myuri, it
indicates an inferior degree of prostration ; and, when the diminished state of
pulsation continues permanent, a greater degree of oppression is indicated.
In the former case the powers of the system seem able to struggle against the
load, but in the latter they are completely overcome. This state is next in
danger to that of complete Asphyxia. These three are the worst kinds of
pulse. The Intermitting is said by Him to be allied to these, being indicative
of great danger, though inferior to that of those we have mentioned. Next to
the Intermitting is the Intercurrent, which indicates that the powers of the
system are strong, but oppressed, and contending against some great load.
Galen was particularly apprehensive of the Intermitting pulse, which he held
to indicate that the system is struggling against some urgent cause. He re^
marks, however, that, when the pulse is otherwise strong and frequent, it in-
dicates less danger than when it is weak and slow. But, upon the whole, he
considered this kind of pulse so full of danger, that he affirms he liad
never known a person recover whose pulse intermitted during the interval of
two pulsations. When the pulse intermits during the space of only one pul-
sation, or a little more, he says he had often seen the patient recover. He also
states, that an Intermitting pulse is less dangerous in old persons than in
adults or children. Some, he says, affirm that they have seen cases of inter-
mission which did not prove dangerous, but he believes that they had con-
founded rarity with intermission. The Intermitting is to be distinguished
from the Rare by the length of the time of rest, and by the latter being often
equable, whereas the former is always unequable. He says it is generally oc-
casioned by frigidity of the heart. These opinions respecting the danger in-
dicated by an Intermitting pulse were called in question by the celebrated
Solano de Luque, who maintained that it is always indicative of a Critical
Diarrhnea. Dr. Nihell, who is a warm abettor of Solano*s doctrine, while be
contends that the Intermitting pulse often indicates a Critical Diarrhoea, allows
that there are exceptions to this rule, for that it often arises from disorders and
impediments of the heart and its blood-vessels, and is sometimes brought on
by spasms, convulsions, weakness, or repletion of the heart. According
Bordeu, the pulse which is indicative of a Critical Diarrhcea, or disorder i
the bowels, is irregular, unequal, and bounding, as well as intermitting; an
he therefore thinks that Solano did not sufficiently attend to its other charac
ters besides its intermissions. Judging from my own experience, I woul
say, that the Intermitting pulse deserves in general the character which Gale
COJIMBNTART ON TBS SSCONO BOOK. 181
{^ives it, although in certain cases it is merely indicative of Intestinal irritation.
I also think it not improbable, that Solano and Nihell may have sometimes
confounded the Irregular and Unequable pulses with the Intermitting; and
Galen decidedly inculcates that the former indicate the presence of Bilious
matters in the primee viae, and prognosticate a Critical vomiting.
Galen, Rhases, and Haly Abbas, repeatedly inculcate that the Undulatory
Pulse indicates an approaching crisis by a sweat. They describe it as being
strong, iiill, soft, bounding, and unequable. This, I am disposed to think, is
the same as the Pulsus Inciduus of Dr. Solano, and the unequally Rising
Pulse of Dr. Nihell, which they represent to be indicative of a Critical sweaty
and describe as consisting of two, three, or four pulsations, rising not only
above the rest, but also gradually as they proceed aoove each other, the second
above the first, and so on. Bordeu represents it as being plein, soupUf deve-
lope, megaUf &c. and holds that it is different from the Undulatory Pulse of
the ancients. It seems probable, however, that they are identical. Wetsch
says that it is called Pulsus lledundans in the Chinese system of the Pulse.
Medic, ex Puis, c. 7.
The Dicrotos is distinguished by a smaller pulsation suddenly succeeding
to a larger one. Galen compares it to a hammer, which, when forcibly struck
against the anvil, rebounds, and strikes it again. The artery in such cases is
always strong and vibratory. Philaretus describes the pulsation as being
bard, vehement, and rebounding. Galen says it can only occur when the
powers of the system are strong, the artery hard, and the body oppressed
with a redundance of humours. He repeatedly inculcates that it indicates an
approaching crisis. There can be no doubt that this is the Double or ite-
bounding pulse of Solano and Nihell, which, according to them, is always in-
dicative of a Critical hemorrhage at the Nose. Whether it uniformly pre-
cedes this crisis, and no other, I cannot, from my own experience, pretend to
determine. Nihell's statement is strong in favour of this prognostic. Of one
hundred and twenty-one persons in whom he observed tlie Rebounding pulse,
seven only showed no tendency to hemorrhage ; the remaining one hundred
and fourteen were all affected either with bleeding at the nose, or symptoms
of determination to the head. But, according to Bordeu, it is only when the
pulse is hard, full, and briskly bounding, that it indicates a hemorrhage at the
nose; for, when it is less hard, less full, and less briskly and steadily rebound-
ing, it rather indicates a discharge of mucus or phlegm from the nose. I
lately detected the Rebounding pulse in a case of Uterine hemorrhage during
pregnancy.
'Die singular pulse called dorcadissanSf which we have translated Goat-leap,
is said to occur most frequently in affections of the Heart and Inflammations
of the parts within the chest. I think I have detected it in such cases.
The Vermicular appears to have been the same as that which is now some-
times denominated Creeping in modem works, and is said by the ancient
authorities to occur in cases of sudden prostration of the vital powers, pro-
duced by inordinate evacuations, such as hemorrhage, cholera, diarrhoea, and
the like.
The pulse called innuens et circumnuens is said to occur only in cases of
extreme debility and danger.
Galen gives the following ingenious explanation why the pulse is con-
tracted and frequent, in cases of acute inflammations. lie remarks that, if a
person have- an inflammation in a limb, he will experience most ease in a
state of complete rest ; but, if obliged, by some urgent necessity, to perform
a journey, he will find, that he can accomplish this most easily by taking
short and frequent steps. In like manner, when any part is inflamed, it
Would afford most relief, if the motion of the arteries could be altogether
suspended for a time; but, as this cannot be, nature renders the dilatation
1S2 COMMXNTART ON THE SECOND BOOK.
as confined as possible, and makes up for its smallness by frequency. — He
U$u Respirationis.
After giving this exposition of the Galenic system of the pulse, we may
well exclaim with Vander Linden : — ** Si qui alii de pulsibus post Galenum
scribunt, ne illi videntur actum agere T — Manuductio ad Medtcirunn,
XIII.-^ON THE ALYINB DI8CHAROB8*
See, in particular, Hippocrates, Prognast, and Galenus, de CriiUmSf c. xi.
Galen remarks, that the stomach may do its office properly, but that, owing
to the heat of the neighbouring parts, the moisture may be dissipated, and
the contents of the bowels rendered too dry ; or that, owing to an imperfect
distribution of the chyle, they may be too liquid. When the alfine discnarges
are soft and consistent, we are certain, that both the digestive and distributive
functions are properly performed, and likewise, that no part within the belly
is in a state of inflammation. He afterwards makes many other ingenimis
observations on this subject, the importance of which, towards the restoration
of health, is now generally admitted. He remarks,, that, agreeably to the
description of Hippocrates ( Prognost,) the proper ailvine evacuation ought
to be yellowish; ibr, if very yellow, it indicates the presence ef too modi
bUe, or, if it do not partake of that colour at all, it indicates that the passage
of the bile to the intestines is stopt. Hhases and Avicenna concur in tms
remark. Mr. Abemethy, by the way, insists, that the colour of the fkces de-
pends principally upon the bile. — (On the Comtitutional Treatment of Local
Viseases.) Galen describes the frothy evacuation, which appears to be the
same as the one resembling yeast described by Dr. Paris. — (On Diet, p.
333.) Hippocrates (Progn,) and Galen make mention of a discharge,
which consists of small, hard, and convoluted portions. This discharge Is
also described by Dr. Paris, u. s. Galen is of opinion, that it is occasioned
by constipation and heat of the bowels.
The account of this subject given by Haly Abbas ( Theor, vii. 16. and
X. 10.) is excellent, although principally collected from the Greek wrHen.
An unctuous discbarge, he remarks, is occasioned by a melting of the &t If
it be viscid at the same time, it indicates also a wasting of the principel
members. A firothy discharge proceeds from heat and flatulence. A grees
eracuation indicates immoderate heat, and the presence of bile. Black die-
charges consist either of black bile, or of common bile blackened by im-
moderate heat This, he says, is the worst appearance of all. If blood is
discharged after the fteces, it may be supposed to come from the small i»>
testines; but if before, from the large; and if mixed with the freces, it
probably comes from the intermediate parts. — See also Alsaharaviusi, Theor,
tr. ix. and Rhases, Cant, xxxi. Rhases states, that white faeces arise from
jaundice. When the discharges are watery, the nourishment of the body is
stopt.
The opinions of Hippocrates and Galen on this subject are conecdy
stated and explained by Prosper Alpinus. De Pressag, Vita et Motte JEgrot,^
lib. vii. c. 11.
XIV. ON THE INDICATIONS VROM THE URINE.
See Hippocrates, Prognost, lib. ii. et de Vict. Acut. c. 46. — Galeni
Comment, de Crisibtis, i. 12. — Celsus, ii. 7. — ^Theophilus de Urinis, — ^A<
tuarius de Urinis, — Aetius, lib. v. — ^Avicenna, lib. iv. fbn 2. tr. 1., Cantic,
1. — Averrhoes, Colliget, iv. 21. — Haly Abbas^ Tkeor, iv. 12, x. 10. — .
OOMMSNTABT ON THE SSOOND BOOK. 188
haraviusy Theor. tr. viii. — Rhaseti, ad Mantor. x. 30. and Contimuij lib.
xxxiw — Psellus, Offut Medicu$n.
Of the ancient authorities who have treated of the urinary discharget,
Theophilas and Actoarius are most particularly deserving of attention ; out
their works contain so many minute obsenrations, that I cannot do justice
to them within the limits to which I am obliged to restrict myself. I must b«
content, therefore, with making a few remarks. Besides the watery portion,
the ancients distinguished three dbtinct substances in the urine, — 1st, TImi
hypostasis or sediment, which is the part that falls to the bottom,--*2d. The
ensBorema, or substances which float m the watery part, but have not weight
to subside,— 3d, The nubeculs, or cloud-like appearances seen floating on the
snr&ce. They state, that the urine of sedentary persons has more sedi-
ment than that of persons who pursue an active course of life ; that the urine of
womm, ffom this cause, has generally more sediment than that of men ; that of
children, more than that of adults ; and that of persons who live grossly,
than the arine of temperate persons. Of the varieties of sediment, Uie fari-
naceous and furfiiraceous, are said to be particularly unfavourable in febrile
complaints, but that sometimes they merely indicate local affections of the
kidneys.
As a specimen of the doctrines of the Arabians, although, in fact, entirely
borrowea from the Greeks, I shall select a few of the observations of Haly
Abbas and Alsaharavius. According to Haly, thinness of the urine in-
dicates deficient digestion. Thickness, on the other hand, is the product of
excessive digestion, or arises from the presence of pituitous humours in the
body. When the sediment is white, it is a favourable symptom ; when
yellow, it is from yellow bile ; when red, it is from a sanguineous plethora
and imperfect digestion ; and if of long continuance, it roust proceed from
in^mmation of the liver. If, after intense redness, the urine become black,
it is a most fiUal symptom. When the urine is moderately fetid, it is con-
nected with indigestion ; but when very fetid, with putrefaction. Alsal»*
ravins delivers the characters of the different kinds of urine in nearly the
same terms. He properly cautions the physician not to allow himself to be
imposed upon by the colour of the urine, which may sometimes acquire a
tinge from the patient's having taken saffron, cassiarlistula, or the like.
Such tficks, he says, are often practised upon water doctors. According to
Rhaiee, it is ao un^vourable symptom when the urine does not become
tmrbid ki the course of the fever. Yellow urine without sediment is said to
be unfevovrable.
Prosper Alpinus has stated correctly the doctrines of Hippocrates and
Galen, but is entirely silent respecting those of Tbeophilus and Actuarius,
u. f .
Besides the ancient authors referred to by us in this chapter, the works
of the following writers de Urhus exist in manuscript, but have never been
publisiied : — 1 . Abicianus, quoted by Labbeus. — 2. Athenaeus, quoted by
Ou Cange, ex Cod. Colbert^ 3614. — 3. Constantinus Africanus, in Bibl.
Cdsiorea. — 4. Joannes Episcopus, Cod. Reg, 3497. — 5. Maximus Planudes
ftnd Meletins Monadius, Cod, Reg, 3175. — 6. Nicephorus Blemmydes^ ia
Bibl. C^sarea, — 7, Anonyraus, &c. Cod, Colb, 3614 and 4230, et in Bibi.
Qtesar,''^. Piropulus in Bibl, Corsliniandy p. 448. — See Fabricii Bibl.
Grac. t. xiii. p. 779.
XV. ON THB INDICATIONS PROM THE SPUTA OR XXPBCTORATIONS.
Galen has treated fully of this subject in his work, de CrisibttSy ii. 10. —
See also Hippocrates, Frognost.9nd Coaca, and Celsiis, ii. 0. Aetius is
>
184 COMIiXNTART ON THK SKCOND BOOK.
somewhat fuller than our author, ▼. 52. — See Avicenna, lib. iv. fen. 2.-*-
Averrhoes, Cantk. p. i. tr. 2. — Ilaly Abbas, Theor. vii. and x. 10. — Rfaases
ad Mansor. x. 24.
We shall be content with giving a few of the observations of the Arabians,
of wh€>in Haly is the most full and accurate upon this head. The lungs and
the other parts within the chest being the organs of life, when affected* they
occasion inflammation of the heart. Expectoration indicates some affection
of those parts. When the expectoration is thin and small in quantity, the
disease is not concocted ; when the sputa are of moderate consistence and
equable, the disease is at its acm^ ^ when thick, it is certainly on thedecline.
Thinness indicates, that the humour which occasions the coinplaint is of a
subtle nature ; thickness, tlie contrary. Blackness indicates vehement beat.
Green sputa are indicative of the presence of green bile, white of phlegm,
and redness of blood. When fetid, they proceed from putrefoction. Black
sputa indicate great danger.
Prosper Alpiniis makes many ingenious remarks on the chaiacters of the
sputa. De Vita tt Marte JEgrot, lib. vii. 19.
XVI. — ON THB DIAGNOSIS AND CURB OF BPHBMBRAL FBVERS.
Among all the records of medicine, there is not, perhaps, any thing more
valuable than the reports of febrile diseases, contained in the Epidemics of
Hippocrates, illustrated, as they fortunately are, by the learned Commentaries
of Galen. Many of them are histories of Ephemeral Fevers, brought on by
certain exciting causes, and frequently terminating in Synochous. The
Procatarctic causes generally assigned are, fatigue, excessive debavcbery,
exposure to extreme heat or cold, and the like.
Of no disease has Galen treated so frequently and fully as of Ferer. —
See de Diff. Febriumy Meth. Med. viii. and ix., Therap, ad Giauc^ de
CrisibuSf ii. 13. et alibi. He everywhere inculcates, that Ephemeral Fevers
are affections of the SpiritSy by which he seems to have understood the heat
and gases contained in the blood. The exciting or remote causes of them,
according to him, are, want of sleep, indigestion, sorrow, fear, anger, anxiety,
tlie application of heat and cold, excessive fisitigue, tumour of the groin, and
the like. He remarks, that the heat in these fevers is not offensive on the
first application of the fingers, but conveys an acrid sensation after a short
time. (By the way. Sir John Pringle makes the same remark respecting the
Jail Fever.) He has particularly stated constriction as a proximate cause of
fever ; and this evidently is the same as the spasm of the extreme vessels in
the Cullenian Theory of Fever. In this variety, he approves of venesection,
unless the patient be a child or a very old man. In the other cases, his
most approved remedy is the Bath ; but his treatment is judiciously varied,
according to circumstances. For example, when the Fever arises from the
depressing passions, he forbids to use hard friction and frequent baths, and
merely directs to pour tepid oil over the patient's body. When it is pro-
duced by exposure to heat, he forbids to use much oil, or to have recourse to
hard friction, and directs to pour upon the head water which has been
cooled by means of ice, and to put the patient into a cold bath. Alexander,
however, finds fault with him for giving heating medicines, such as pepper,.
and using hot applications over the stomach in such cases. Alexander s ac —
count of the nature and treatment of these fevers cannot be perused with to<^
liiuch attention. They arise, he says, from many and various causes, sucl^
as repletion, want, watchfulness, fatigue, disorder ofthe belly, apostemes; and .9.
in a uord, from all the procatarctic causes. When the fever is occasioned b_
f xcessive fatigue, the indication, he slates, is to supply mobture to the bod^
COMJISNTAET ON THB 8BC0ND AOOK. 186
ratlier ilian take from it. Ilence, all friction with discutieot oiU ouglit to be
avoided ; and what is used for rubbing the body should be mixed with
much water ; but the principal dependence is to be put upon the tepid bath.
Here, again, he thinks that Galen erred, in not directing that the oil used for
rubbing the body should be diluted with water.
Oribasius and Aetius treat of Ephemeral Fevers in much the same terms as
our author.
Palladius says, that Ephemerals are affections of the spiritt, arising from
some external exciting cause, such as fatigue, intoxication, anxiety, watchftil-
oess, or from a tumour of the groin. Celsus ^ves a similar enumeration of
the causes, but in briefer terms : — *' Febris ex uguine, Tel ex lassitudine, vtl
ex spstu, aUi&ve simili re est.** Almost all the authorities ftx>m Hippocratet,
downwards, mention enlargement of the glands, especially those of the groin,
among the causes of fever. Agathias the historian remarks, that Pestilential
Fever is attended with enlargement of the inguinal glands, but does terminate
fiivoorably in one day, like the Ephemerals. Hitt, lib. v.
Nonnus enumerates nearly the same causes of these fevers as our author,
whom he appears to have followed closely. He remarks, that Ephememk
are sometimes protracted to the third or fourth day, from which it appears
that the term is not to be taken in too strict a sense.
Synesius treats of Ephemeral Fevers with great accuracy, so that we have
reason to regret that the text of this author should be so corrupt. Like pre>
ceding author^ he enumerates, among the exciting causes, abscess of the
glands of the groin, neck, and armpits, the beat of which, he says, being de»
tennined to the heart, kindles a fever. In this case he recommends discu-
tient and emollient applications, such as mallows, linseed, and the like. The
account given by Constantinus Africanus is exactly similar to his.
Actuarius mentions the same causes, and briefly recommends the same
treatment as our author.
Haly Abbas gives a most distinct and accurate account of the phenomena
of Ephemeral Fevers, according to the nature of their remote causes. The
Isi Class are produced by external causes, such as exposure to the heat of
the sun, hot baths, or astringents which occasion constriction of the pores of
the skin. He also inculcates that these causes may likewise nve rise to Sy«
nochous, or Putrid Fevers. The 2d Class are prod uced by calemcient food and
medicines. The 3d Class are occasioned by immoderate exercise, or violent
passions, such as anger, fear, and the like. The 4th are sympathetic affec-
tions proceeding from inflammatory swellings of the glands. He remarks,
thai in certain kinds of fever the increase of heat is not felt upon the first ap-
plication of the hand, owing to constriction of the pores. Theor. viii. 3. l£s
treatment merits attention. When tlie fever arises from a hot cause, he di-
rects to pour refrigerant liquids, such as vinegar, rose oil, and the like, upon the
beady and to apply to tlie forehead a cloth moistened with the same. When
tlie fever is produced by cold, he recommends the warm bath, with friction,
in order to promote perspiration ; after which caleiacients may be given ; but
he forbids wine, if the exciting cause be great, lest it should occasion a con-
version of the complaint into a Putrid Fever, which, as he remarks, Galen
stales not to be an uncommon occurrence. To prevent this, he recommends
to have recourse to venebection and the liberal administration of diluents.
The next class of Ephemerals of which he treats are Intestinal Fevers origi-
nating in errors of food and drink. For these he recommends cooling
drink, cooling articles of food, clysters, eccoprotics, and the like. When
the fever is brought on by violent labour, he recommends the tepid bath,
(gentle friction with emollient oils, light food, and a spare allowance of wine,
provided the patient has been habituated to it. When the fever is produced
by violent emotions of the mind, he recommends the tepid bath, refrigerant
186 comfBHTAmr on tbx sbcond booi^.
ibody camphor, and the like. When it ari8<^ firom sorrow, he directs to have
recourse to treatment of an exhilarating nature, the bath, wine, and so forth.
For fever brought on by vrant of sleep, he recommends soothing treatment,
the atfiision of tepid water, and wine, if the patient has been accustomed to
it. In fevers arising from glandular swellings, he directs to have recourse to
venesection, and forbids the use of the bath and of wine. This is somewhat
different from our author's treatment. The account of the causes and treatment
of ephtmerals given by Alsaharavius is so like that of Haly Abbas, that I shall
not enter particularly upon it. *Serapion, Averrboes, and Avenzoar, give sensible
expositions of the causes and cure of these fevers; but there is little in them
worthy of attention that is not derived from the Greeks. Avensoar states
distinetlTy that, if neglected or mismanaged, they are apt to be converted in-
to potrio, or synochous fevers. For ephemerals occasioned by labour, he re-
comrncods the tepid bath, and friction with the pulp of melons. Avicenna
remarks, that if, in ephemerels, the blood become inflamed, the fever is apt
to be converted into sjmochous, or, if it become putrid, into putrid fever.
This, he says, is particularly the case, when the ephemeral fever is connected
with obstruction of the pores of the skin. For the cure of this species, he
approves of venesection. He recommends the same remedy, when the
disease arises from drinking too much wine, or from aposteme of the groin,
armpits, or neck. His expositor, Syrasis, particularly commends the tepid
affusion in ephemerals. Ithases joins in enforcing the same practice as
Avioenna. He gives a most comprehensive account of the causes of these
fevers. Like all the other authorities, he decidedly inculcates this important
feet, that, although ephemeral fever be in itself neither serious nor ratal, it
may be converted into a vehement and acute fever, when any error is com-
mitted in the regimen or method of cure. Constriction, he says, may take
place, either in the pores of the skin, or in the internal parts, and is gene-
rally occasioned by cold or astringents. This is one of the causes of fever.
The others are, immoderate exercise, the application of heat, food of a heat^
ing nature, and putridity.
A "^cording to Prosper Alpinus, the Methodists held, that the proximate
cause of fever is constriction. Galen, as we have stated, held this to be one
ofnhe causes, but not the sole one. The Methodists, like our Cullen and
Hoffman, seem to have generalised too much. Their most approved re-
medies were the warm bath, and friction with emollient oils. De Mediema
Methodica, lib. v.
The earlier modem writers on medicine give the same account of ephe-
merals as their ancient masters, whose views in all cases they servilely adopt.
— nSee Rogerius, Tract, iii. and Platearius de FebrUmt, Rogerins correctly
remarks, Uiat ephemeral fever, from enlargement of the glands, is merely
symptomatic. The causes of ephemerals, as enumerated by him, are, ex-
posure to extremes of heat and cold, food and drink of a heating nature,
strong exercise, violent passions of the mind, and the like. Platearius re-
marks that, if an ephemeral be prolonged beyond the third or fourth day, it
is apt to be converted into a putrid fever.
XVII.— ON PUTRID FBVBES.
Tnis chapter is mostly taken from Oribasius, Synop, vi. 7. Many of the
histories in the £pidemics of Hippocrates are Synochous Fevers, accom-
panied with putrefaction of the nuids. Galen remarks, that they occur
principally in persons of a plethoric and gross habit of body. Meik, Med,
nb. viii. According to him, Putrid Fevers may either arise from the con-
version of ephemerals, or originally from putrefaction of the fluids within the
COMMSIITAET ON THB SSCOND BOOK. 187
vessels. De Dijf, Feh» i. 9. Aetius steles, that they arise from coDstrictioo
of the skilly or viscidity of the humoure, whereby the perspiration is st«pt,
and the quality of the Titai heat so altered, as to give rise to putrefactioB,
first of tlra fluids, and afterwards of the &t and solid parts. When these
corrupted fluids are oootained within the vessels, they occasion Synochoos
Fevers ; but, when distributed over the body, they give rise to Intermittenls.
lib. V, 74. Synesius and Constantinus AfHcanus give a similar accoanl.
Alexander gives an interesting and ingenious disquisition on the origin and
nature of Putrid Fevers, one of the most common causes of which be holds to
be the conversion of Ephemeral Fevers. This is the account of them given
by moet of the other authorities, both Greek and Arabian, so that I need not
enter into any very circumstantial exposition of their views. I shall
merely give the brief account of them nimished by Palladius. There are,
he says, two kinds of Synochous Fevers, the one being occasioned by e^
ferve&cence, and the other by putrefaction of the blood ; of these, the latttr
are the more protracted and dangerous. In them the pulse is contracted,
the heat pungent, and the urine white and putrid. Among the Arabiaiis,
see, in particular, AJsaharevius, lib. xxxii. §. 6. — Haly Abbas, Theor, viiL 5.
and Rhasee, Conthensy lib. xxx. Rhases states, that Putrid Fevers art
often engendered by eaung too much fruit, such as peaches. He says, they
generally b^n with depression of the pulse, horripilation, torpor, aod
sonmolaicy.
XyiII.*^-*ON THB CVBB OF PUTBID FBVBB8.
All subsequent writers on this subject are indebted to Galen, for laying
down, in the most satisfiurtory terms, the principles upon which the treat-
ment of Putrid Fevers ought to be conducted. He particularly recommends
bleeding ad deliquium. When this evacuation is neglected, the patient's
only chance of safety is from a spontaneous hemorrhage, or profuse perspin^
tio«. He is so confident in the remedial powers of venesection, that he di-
rscts it to be performed as late as the seventh day, and even later, if the
strength of the patient permit. He particularly directs, likewise, to allow
the patient to drink as much as he chooses of the coldest water, whidi, Im
says, when seasoasd^y administered, is most efficacious in extinguishing the
febrile heat. This remedy, however, he says, is to be used with becoming
caution. But, upon the whole, he strenuously inculcates, that the safety of
the patient depends upon the free use of phlebotomy and cold drink. When
the fever abates, he allows wine. Alexander, although sufficiently disposed to
difii&r ftom Galen, entirely concurs with him in opinion respecting the
treatment of Putrid Fevers, for which he particularly commends bleeding
and cold driak. When venesection is contraindicated by the weakness of
the patient, he is to be treated by a refrigerant and diluent regimen.
Aetius and Oribasius follow Galen, and their treatment, fiierefore, agrett
perfectly with our author's. Synesius and Constantinus Africanus agree la
recommending bleeding and cold drink. But, when the patient is very
weak, they forbid to have recourse to the former, and, in that case, direct to
use gentle aperients, and medicines of a refrigerant and diluent nature, socb
as prunes, ittjufoes, pur^ain, and the like.
Although Avicenna lays little claim to originality, his plan of treatment io
diis case is deserving of attention, as being directed by the soundest iudfp^
ment. He begins with venesection, if the patient's strength permit, and thmi
opens the belly genlly, but cautions against violent purging. He then gvn$
first diuretics, and afterwards sudorifics. Unless vrnen the stomach is loaded
with crudities^ he approves very much of cold drink. Though fevourable to
188 COMMSNTART ON THE SECOND BOOK.
the seasonable practice of venesection, he forbids it, except at the commence-
ment ; and directs to proportion the loss of blood to the strength of the pa-
tient, lie also forbids to interfere with the crisis by bleeding, purging, or
giving gross food at that season. Further, with regard to venesection, he
does not approve of abstracting much blood at once, which may occasion a
dangerous prostration of strength ; but prefers taking a moderate quantity,
and repeating the operation, if necessary. The pui*gatives which he most
commends are tamarinds and myrobalans; but, when these are not suf«
ficiently strong, he permits to give scammony, aloes, and colocynth. He also
directs to give camphor as a refrigerant. It is to be kept in mind, that the
Arabians held the action of camphor to be frigorific, that is to say, narcotic.
He is most minute \n his directions about the diet. For drink, he gives
barley-water, with a small proportion of wine or vinegar.
Haly Abbas lays down the rules of treatment with great precision. He
recommends venesection at the commencement, provided the fever be of a
sanguineous type ; but, if the patient be debilitated, he is to be treated with
refrigerants.
Averrhoes treats of Putrid Fevers at great length, and with more than his
usual judgment ; but, as he differs but little from Avicenna, we shall not at-
tempt to give an abstract of his practice. Collig, vii. 9. Rhases gives a full
account of the practice of the Greeks. When the extremities are cold, and
the pulse weak, he directs to rub them, in order to draw off the blood from
the mternal parts.
The practice of Dr. Robert Jackson in Putrid Fever was very similar to
that of Galen and other ancient authorities. He approved of bleeding, of
rubbing the body with stimulant and antiseptic substances, and afterwsirds
of giving grateful wines, such as the Rhenish and Champaigne.
Alexander Aphrodisieus inquires how it happens, that wine, which is of a
hot nature, proves useful in fever. The amount of his speculations upon this
matter is this, that the wine acts by strengthening the powers of the system.
Probl.
All the ancient authorities disapprove of the bath, except in the decline of
the fever. — See Ugulinus de Balneis, Rabbi Moyses says, that the use of
it is to be regulated by three circumstances: — 1st, That no rigor be pre*
sent. — 2d, That no important member be affected. — 3d, That there be no
crudities in the veins. These appear to be very judicious regulations.
XIX. THE DIAGNOSIS OF TERTIANS.
Hippocrates relates many interesting cases of Tertian Fevers in his Epi-
demics. He attributes their origin to bile. De Natura Humana^ c. 29,
Celsus describes two kinds of the Tertian, the one beginning with shivering,
and being succeeded by heat, the paroxysm returning every alternate day;
and the oth6r constituting the Semi-tertian, of which we will have to treat
afterwards.
Galen treats of these Fevers in different parts of his works, as, in Hippo-
crat. Epideni. Comment,, Therap, ad Glattc., de Different, Feb. ii. 3., de
TypiSf c. 3. The symptoms of tne Tertian are thus described by him: — It
is attended with intense thirst, heat, acrid and bilious vomitings, loss of ap-
petite, and restlessness. For the most part, these symptoms are preceded by
rigors, or sometimes by extreme coldness. The pulse in Tertians b small
and dense. At first, the night preceding an attack is past in a restless state,
but after the disease is prolonged this is not the case. The urine is yellow.
In many parts of his works, he announces it as his decided opinion, that the
Quotidian Intermittent is produced by phlegm ; the Tertian oy. yellow bile ;
COMMBNTART ON THB 8KC0ND BOOK. 189
and the Quartan by black bile. This theory of Interraittents was adopted, in
a word, by all his successors. — See Oribasius, Synop. vi. 9. — Aetius, v. 80. —
Nonnus de FebribuSy c. 6. — Palladius de Febr, c. 6.*-Alexander, lib. xii. 6.
-nSynesiuSy c. iii. — ^Avicenna, lib. iv. fen. 1. tr. 2. — Haly Abbas, Theor.
lib. viii. — Serapkm, vi. 13. — Avenzoar, iii.tr. I.e. 2. — ^Averrhoes, CoUig.
iv. 28.
Sprepgel informs us, that Professor Eisner adopted the ancient theory of
Intermittents, according to which the Tertian is supposed to arise from bile,
the Quotidian from phlegm, and the Quartan from black bile. Hitt. de la
Medic,
Mr. Cleghorn's observations on the bodies of more than a hundred per-
sons who died of Tertians confirm the accuracy of the ancient tlieory with
regard to them. He mentions, that he constantly found tlie Vesica FeUea
full and turgid, and the stomach and intestines overflowing with bilious
matter. Dit, of Minorca,
XX.-— ON THB CURB OF TERTIANS.
Hippocrates recommends generally purgatives at the commencement,
and afterwards the hot bath, and trifoly, assafoetida, and wine, to promote
perspiration. De Morbis,ii.39.
Celsus informs us, that Cleophantus treated Tertians, by pouring warm
water upon the patient's head, and giving him wine before the accession of a
paroxysm. This, however, he considers to be precarious practice. Upon
the whole, his great dependence is upon these three remedies, vomits,
purgatives, and wine, of which the first is to be tried on the third day, the
second on the fifth, and the third on the seventh.
Galen's practice is exactly detailed by our author. He evacuates the bile
upwards and dovmwards at the commencement, and also with the same in-
tention administers diuretics and sudorifics. After these, he reposes great
confidence in wormwood, which, indeed, all the ancients held to be a power-
ftil cholagogue. He also approves much of the tepid bath of common water.
He forbids wine until after the fever is concoctea, but afterwards allows a
small quantity of a thin watery wine. The food is to be refrigerant and
diluent. Every thingot a heating and acrid nature is to be abstained firom.
Aetius, Oribasius, and Nonnus, conduct the treatment upon the principles
laid down by Galen. Actuarius directs to bleed at the commencement.
Alexander discusses the established principles of treatment freely and
fiilly. He disapproves of Galen's practice of giving the decoction of worm-
wood in the Genuine or True Tertian, after the seventh day, and confines
the administration of it to Spurious Tertians, when he mixes it with oxymeL
His own remedies are of a diluent and refrigerant nature. He approves
very much of the bath. He speaks highly of die good efiects of grapes and
peaches, and still more of water-melons given with cold water before the fit.
He approves of gentle, but not of strong purgatives.
Synesius recommends cooling articles, such as damascenes, gourds, &c.but
says nothing of wormwood. Constantinus Africanus also omits to make
mention either of wormwood or the tepid bath. He permits, however, to
pour water on the head, and to put the feet into hot water.
Serapion directs to give emetics, if the matters are determined to the
stomacn, and clysters, or gentle purgatives, if to the bowels. He recommends
to give myrobalans afterwards, and then wormwood, but not until the mor-
bific matter is concocted. Tr. vii. 13.
Hhases recommends gentle and cooling purgatives, with refrigerant and
190 COMMKMTABT ON THB SBCONB BOOK.
diluent drinks, containing sorrel, cucumber, camphor, &c. Ad Mansor,
z. 4.
Avicenna*8 directions are exceedingly minute, and seemingly very judi-
oious. He cautions against using drastic porgatives, and expresses himself
doubtfully of the effect of ?enesectioo. His practice consists principally in
the administration of gentle purgatives, diluent and refrigerant medicines.
He approves of pomegranates, plums, and water-melons. Averrhoes lays
down the same princijSes of practice. CoUiget,r\i. It. ilaly Abbas states,
that, as it is the nature of these fevers to occasion heat and dryness of the
body, they are to be treated with diluents and refrigerants. Agreeably to
these principles, he directs to give clysters and gentle laxatives, to use the
tepid affusion, and the like. Pract, i\i. 12. Alsaharavius recommends si-
milar treatment. Uhases, like Haly, recommends refrigerants and diluents.
He approves of cooling purgatives, such as a combination of myrobalans and
scammony, or a draught made from prunes and manna. He speaks favour-
ably of emetics. Several of his authorities recommend the bath, and others
approve of wormwood. ContinenSy lib. xxx.
It will be remarked, that many of the ancient authorities recommend the
tepid baih for the cure of Tertian Intermittents. Prosper Alpinus informs
us, that he had seen this practice successfully pursued by the Egyptian physi-
cians. De Med. Mgypt.
XXI.— -ON SPURIOUS TXBTIANS.
Galen explains, that Tertians are called Spurious or Bastard, when the
symptoms assume ao anomalous character. He states correctly, that they
are generally connected with disease of the spleen. His practice, which is
consistent with his views of the nature of the attack, is similar to our author's,
that is to say, he recommends venesection and fomentations at the com-
ntencement, and afiterwards things of a hot penetrating nature, such as worm-
wood and pepper, which he, no doubt, gives with the intention, that they
sbcrald act as deobstruents. Here, again, Alexander cautions against the indis-
criminate adoption of Galen's practice, affirming that these calefacient medi-
cines sometimes proves dangerous, by increasing the inflammatory action.
Almost all the other authorities, however, adopt the views of Galen. — ^See, in
particttlar, Oribasius, Synop* vi. 11. — Aetius, v. 81. — Nonnns<fe FebrUmty c.
5. Avicenna, in like manner, recommends at first venesection and clysters;
and afterwards deobstixient medicines, such as wormwood and pepper. Haly
Abbas directs to treat Spurious Tertians like True, at the comnofebcement.
After their acm6, he strongly recommends wormwood, but forbids to give it
eariier. It acts, he says, by increasing the strength of the stomach, opening
the pores, increasing the urine, and promoting the secretion of bile. He ap«
proves of wine in the decline of the Fever, with the view of supporting the
strength, and of promoting the urinary and cutaneous secretions. He, there-
fore, directs that the wine be white, and not too old. Prttct. iii. 13.'
From the account of the ancient practice in cases of Tertians, as given in
this and the preceding chapter, it will be seen, that the use of bitters in these
diseases was well understood formerly. Their beneficial effects are now ge-
nerally acknowledged. Dr. Cullen says, — " 1 hold it to be established as a
ftu:t, that both astringents and bitters, in their simple and separate state, have
proved often sufficient to prevent the recurrence of the paroxysms of inter-
mittent fevers ; and that tney more certainly do so when combined together.''
Materia Medica, ii. 92.
Dr. Thomas informs us, that he had known many cases of intermittent
fevers which yielded to quassia, after having resisted the powers of cinchona.
COMMINTABT OM THE 8KC0MD BOOK. 191
• *
He agrees with the aqcieiito in recommend ing stonacbic biuers and dii^
retics for removing scirrhosity of the liver and spleen, brought on by ioier-
mitteat foveiB. The use of pepper for intennittents has been much cried up
by the American and Italian physicians of late. They affirm that it is mofft
eiiicacious than cinchona.
XXII. ON THB OIAONOBIB OF dUABTANS.
Wjb mentioned in the 18th chapter, that the ancients held Quartans to be
occasioned by an accumulation of black bile, lience, says Hippocrates^
tb^ prevail most in autumn, and attack persons between the ages or twenty.-
five and foity-five. De ^at. Hum, c. 29. lie recommends principally for theoB
emetics, purgatives, and the warm bath. De Affect, c. 1 9. By wandering feven^
of whidi mention is made by our author, is meant fevers, the paroxysms of
which return after an interval of many days. — See llippocr. Epidem. — Rhases
ad Mamor, z. 8.
Our author*s description is condensed from Galen (Tkerap. ad Glauc,
lib. i.)y or probably copied direct from Oribasius {St^nop. vi. 12.) Galen
states, that Quartans are of a less inflammatory nature than Tertians, and
hence the pulse is slower and smaller. liuf!us (Ap. Aetii lib. v. c. 83.) rfr*
fers the origin of certain Quartans to the spleen ; and, no doubt, it is fre-
quently diseased. Alexander says, that Quartans arise from yellow bile
overheated, or from feculent blood, these humours being lodged either in the
vessels or in the spleen. Palladius, Nonnus, Synesius, and, in a word, all
the Greek authorities, give a similar account of the nature of Quartans. Con*-
stantinus Africanus says, that a paroxysm lasts for 24 hours, and is succeeded
by an interval of 48 hours. The urine is at first white and watery, but is
the decline becomes black. Ue mentions, that it is connected with induitr
tion of the spleen.
As there is nothing original in the theory and descriptions which the
Arabians give of Quartans, we shall not enter upon them minutely. Avenw
hoes states, that the fever invades with a great sense of cold, so that tlie par
tient's teeth chatter. The colour of the urine at first inclines to green, or is
somewliat white; but afterwards it becomes gross, black, or reddish. The
interval between the paroxysms is two days. The most of those affected with
Quartans have disease of the ^leen. AJsaharavius gives exactly the sam^
account of these fevers. Avicenna*s description is most ample and coiiipre>-
bensire, batcootaim no additional facts to those we have already mentioned.
Ualy Abbi% Aventoar, and Rhases, in like mannner, adopt the views of the
Greeks.
XXIU.— ON THE CUBS OP QUARTANS.
Tbis chapter is copied from Oribasius, Synop, vi. 13. Galen, however, is
the great authority upon this subject. With respect to venesection, he directs
to have recourse to it only when there is a plethora of blood ; but recom-
mends, when a vein has been opened, and the blood found to be black and
thick, especially in the case of diseased spleen, to abstract blood until it
change its colour. He approves of laxatives, and clysters, at first emollient,
*^iid afiberwards acrid. He forbids to use those things which were supposed
to engender black bile, and recommends a thin white wine. He speaks fa-
vourably of pepper. When the disease is come to its acm6, he recommends
^o rectify the state of the viscera by fomentations and cataplasms, and by ad-
<^inislering melanogogues, especially hellebore, in such quantity as to operate
^.o-""'
COMMXNTARY ON THS 8SC0MD BOOK. 193
Fe?er, is at great pains to explain the manner in which putrid extra?asated
Phlegm gives rise to Quotidian, lie represents the heat as being smothered
and concealed like that of moist fuel. Celsus describes all the varieties of
the disease very minutely. Constantinus Africanus gives an accurate de-
scription of this intermittent. He says that the paroxysm lasts for 24 (18 ?)
hours, and is followed by an interval of 6 hours. First, old persons, and
then boysy are said to be peculiarly subject to the disease, which is apt to
make its attack in cold countries and at cold seasons of the year. It is at-
tended with a great degree of cold, especially of the extremities, the face is
swelled, the colour pale, and no thirst is present.
As the Arabians give the same account of the origin and symptoms of
Quotidians, we need not enter upon a detail of their descriptions. All agree
that they are connected with Phlegm as an exciting cause, and that the Fever
is less ardent and well marked than in the case of Tertians.
XXV. — ON THE CURE 09 QUOTIDIANS.
This chapter is taken from Oribasius, Syn^pn. vi. 14.
Celsus enjoins abstinence for three days; after which, food is to be taken
every alternate day. After tl>e fever has subsided, he recommends the bath
and wine.
€ralen*s treatment is exactly the same as Our author's. Alexander, as usual,
makes nice distinctions as to the circumstances under which each of the
neroedies ought to be applied. In general, he approves of incisive and at-
tenuant medicines, but blames Galen for recommending the latter too in-
discriminately. He forbids cataplasms and embrocations at the commence-
ment, lestihey should occasion a determination of the humours to the affected
part.
Synesius appears to have proceeded upon much the same principles as our
author, but he makes mention of some additional medicines, such as camphor,
wormwood, and the like.
Nooous recommends, at first, things of an incisive and attennant nature,
and then emetics, after which, the phlegm is to be purged by means of colo-
cynth and agaric, and cataplasms and fomentations are to be applied to the
pit of the stomach.
Avicenna lays down the rules of treatment with so great minuteness, that
I cannot venture upon an abridgment of them. His prracipies, however,
seem to be the same as those of Galen. Averrboes recommends, for the 6rst
seven days, medicines of an incisive, attenuant, and deobstruent nature. He
then directs to give cathartics which evacuate phlegm, such as turbith,
agaric, and hiera picra, but forbids the use of colocynth. He approves very
much of friction, the mode of applying which is minutely described by him.
Bhases recommends much the same treatment. He, in particular, directs to
give turbith and agaric along with wormwood and mastich. Haly's remedies
are mostly diluents and attenuants. Alsaharavius recommends the same
remedies as Rhases.
XXVI. ON THB HBPIALUS, AND RIGOR WITHOUT HEAT.
Hippocrates applies the term Hepialus to a Fever occasioned by Ame-
norrfacea. Galen enters minutely into the consideration of the nature and
^^ises of the Hepialus, which appears to be a variety of the Quotidian In-
^fmittent. He says the fever derives its origin from the putiefaction of a
o
9»
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COMMENTARY ON THB 8BCONO BOOK. 195
symptoms. He also remarks their tendeDcy to terminate in Dysenteries,
Lienteries, and Tenesmus.
Gralen marks a distinction between the Continual Terer (<rw€xos) and the
Synochus, which it is necessary that the reader should particularly attend to.
He remarks that there are three varieties of Intermittents — the Quotidian,
which arises from putrid phlegm ; the Tertian, from yellow bile ; and the
Quartan, from black bile. Of Continual Fevers, arising from yellow bile,
there are two species, the one being called Synochi, and consisting of one
paroxysm from oeginning to end, and the other, to which the generic appellap
tion Continual (<jvp€xut) is particularly applied, and which consists of a
number of particular paroxysms. Of the Continual Fevers, some assume the
Tertian type, having a remission of the fever every alternate day ; some the
Quotidian, and have a remission every day ; and others, of rare occurrence,
resemble the Quartans, in having remissions after an interval of three days.
De Diff. Feb. ii. 2. In another place, he says of Synochous Fevers that they
consist of two varieties, the one arising from an ebullition of the blood, and
being produced by the conversion of Ephemerals, and the other arising from
putrefaction of the blood in persons who are gross and plethoric. Metk*
Med. lib. ix.
Aetius treats of Continual Fevers (avv€xfis) in nearly the same terms as
our author, and distinguishes them from the Synochi.
Alexander states that the Continual Fevers (oxfyc^^ts) differ from the In-
termittents, solely from the humours which occasion the former being of a
thicker nature.
Our author's account is nearly copied word for word from Oribasius.
Actuarius remarks, that the Synochus proceeds from an ebullition of the
blood, and the Continual Fever {avv€xr}s) from putrefaction of the different
humours.
Nonnus states very distinctly tlie difference between the Synochus and
Continual Fever. In the latter, he says, there is an incomplete remission of
the febrile symptoms, but in the former there is no remission at all.
Synesius and Constantinus Africanus adopt the distinction between the
Synochus and Continual Fever, as stated by Galen.
Celsus, although he does not describe the Febres Continue very particu-
larly, seems to allude to them in his account of the Quotidians : — *' Rursus
aHs sic desinunt, ut ex toto sequatur integritas; alise sic, ut aliquantum
3uidem minuatur ex febre, nihilominus tamen qusdam reliquiae remaneant,
onec altera accessio accedat ; ac saepe alias vix quidquam aut nihil remit-
tant, sed ita ut continuent."
In the works of Rhases, the distinction between the Continual and Sy-
nochous Fevers is clearly pointed out. lie states that the Synochus, or Con-
tinenSf is a Fever which consists of one paroxysm from beginning to end,
whereas the Continual, called awexrjs by the Greeks, and F. Contimui by
the Romans, is allied to the Intermittents.
In the barbarous translation of Alsaharavius, there is some difficulty in
recognising this distinction. He first describes a Fever, which he denomi-
nates Synocha, which arises, he says, from iDflammation of the blood, and is
marked by redness of the face, headach, and difficulty of breathing. 2d,
Nearly allied to it is the Synochus or Febris Continua (it ought to be JP.
Continens), which arises from putrefaction of the blood. 3d, The Febris
Quotidiana Continua, the Febris Tertiana Continua, and the Febris Quar-
tana Continua, which are distinguished from their corresponding Intermit-
tents by being attended with a partial remission and not a complete inter-
mission of the Febrile symptoms.
Avicenna describes the Tertian Intermittent by the name of Febris Ter-
tiana Periodica, and the Continual Tertian by that of Tertiana Continua ;
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COMMENTARY ON THE SECOND BOOK. 197
Therap, ad GUiuc, lib. i. He forbids the Bath when inilammatioD is pre-
sent, ifyg.
Aetius conducts the treatment upon the same principles as Galen, and the
directions which he gives for the application ot the different remedies are
most important, lie states most decidedly, that, unless venesection is had
recourse to, the patient will be in the utmost danger, and can only be saved
by tlie strength of his constitution, or some critical evacuation. When the
stomach is loaded, however, he forbids depletion, because, by emptying the
veins, the distribution of the crudities in the prima via will be accelerated.
When the Menstrual, or Hemorrhoidal discharge is expected, be directs to
bleed less profusely than otherwise. Persons of a hard, san^ine, and com-
pact habit of body, are said to bear bleeding best. In practising venesection,
he directs the physician to pay more attention to the strength of the patient
than to the period of the Fever. He is particularly earnest in recommend-
ing the use of cold drink. He directs to give it at the acm^ of the disease^
but not at the commencement. He forbids to administer it freely when there
is obstruction or inflammation of an internal viscus ; and states many serious
evils which may arise from the unseasonable administration of cold water^
although it be an excellent remedy when given at the proper time. With re-
gard to diet, he directs to give nothing but ptisan for tiie first three days.
On the fourth, he recommends to use the bath. Through the whole course
of the fever, the food is to be light, unless the powers of the patient be very
feeble.
As the other Greek authorities differ in no material respect from the prin-
ciples of treatment laid down by Galen and Aetius, we need not enter upon
any minute exposition of their views of practice. As a specimen, however,
of the practice of the later authors, we shall briefly mention that of Synesius
and CoBstantinus Africanus. They approve of bleeding, unless the stomach
be loaded with crudities; in which case, they forbid the operation until these
are concocted or discharged. They recommend diluents ; and, if the belly is
constipated, clysters, with decoctions containing tamarinds, damascenes,
manna, and the like. To remove the remains of the Febrile excitement in
the decline of the fever, they direct to give medicines of a refrigerant nature,
such as camphor, the seeds of melons, cucumbers, gourds, and the like.
Celsus jecommends venesection in all Fevers at the commencement, pro-
vided the patient is not very young, weak, or has crudities in his stomach ;
but af^er the fourth day he does not approve of it. He also makes some in-
genious remarks on the contrary methods of giving water and wine in cases
of Fever. He recommends the latter, when there is cold, torpor, and rest-
lessness. He likewise mentions the affusion of cold water and oil, with the
intention of changing the morbid state of action.
In an Epistle of Vindicianus, physician to the Emperor Valentinian, there
is an interesting history of a Fever, arising from indigestion and obstruction
of the bowels, brought on by excess in eating and drinking. In this case,
Vindicianus, in opposition to the advice of the other professional attendants,
would not administer a clyster, and gave his patient nothing but salt and
^ater, which procured first copious perspirations, and afterwards free evacu-
ations of the bowels. He then directed him to use the bath, and completed
the cure by giving wormwood to remove obstructions. This is a well-marked
case of Intestinal Fever. Fabricii BibL Grac.T. xiii.
Haly Abbas, during the first three days, strongly recommends venesection,
^bich, he says, will either have the effect of cutting short the Fever at once,
<)r of rendering it milder. His other remedies are altogether refrigerant, con-
sisting of acidulated drinks, and gentle purgatives, such as prunes, tamarinds,
'"^nd the like. Alsaharavius, in like manner, recommends depletion, and the
refrigerant plan of treatment.
198 COMMKNTART ON THE SECOND BOOM.
Serapion strongly recommends bleeding ad deliquium animi, which, he
says, will probably have the effect of procuring discharges from the bowels,
and of promoting perspiration. He admits of venesection even after the
sixth or seventh day, when other circumstances indicate it. He further directs
to administer refrigerant remedies, such as tamarinds, cassia-fistula, and the
like.
Averrhoes, although he approves of venesection, condemns Galen's direc-
tion to carry it the length of bringing on deliquium animi. He also cautions
against carrying the administration of cold drink too far.
Avenzoar strongly recommends bleeding ad deliquium. Avicenna like-
wise approves of this practice. When the strength does not permit to carry
depletion so far, he directs to open the Temporal veins, or to abstract blood^
by cupping. In such cases, he also recommends purgatives and refrigerant
medicines. Towards the conclusion of the Fever, be directs to give the Tro-
chisks of Camphor.
Rhases gives an excellent account of Synochus. His remedies are bleed-
ing, gentle purgatives, acidulated drinks, restricted diet, and complete absti-
nence from wine. He particularly recommends Aloes as a purgative. See^
in particular, Continens. lib. xxx. tr. v. c. 2. He approves of the bath, but
prefers delaying the use of it until the decline of the Fever. He is very de-
cided in recommending bleeding, unless the patient be of a weak constitu-
tion, or his system loaded with crudities. Alter the Fever is concocted, be
approves of giving cold water freely for drink.
XXIX. ON ARDENT FEVERS.
Our author's description of the Camus, or Ardent Fever, is taken from
Hippocrates, de Ratione Victus Acut, where the Commentary of Galen is
worth consulting. According to Hippocrates, the Causus is generally pro-
duced in the summer season, owing to the veins becoming dry and attracting
Bilious humours. In other parts of his works, he gives an account of seve-
ral varieties of the disease, differing considerably in character from that de-
scribed in the above-mentioned work. For example, one variety mentioned
in his Epidemics was distinguished by the absence of thirst and delirium, and
by the paroxysms occurring on the even days. See Galen's Commentary,
Operay Ed, Basil, T. v. p. 424. Also, de Morhis, i. 27.
Aretseus delivers a most striking description of Ardent Fevers, which I re-
gret that my limits prevent me from giving at full length. The following are
some of the most important symptoms : — the heat acrid and subtile, especial-
ly in the internal parts, desire of cold air and of cold things, the extremities
cold, the pulse dense and small, the eyes clear, bright, arid reddish; and, if
the Fever go on increasing, delirium, oblivion of every thing, lividity of the
nails, frequent respiration, profuse perspiration about the forehead and neck,
coldness of the body, and at last a complete collapse marked by a return of
,the powers of reason and certain indications of a prophetic spirit. This is
but a meagre outline of his matchless delineation of the phenomena of
Causus.
As all the Greek, Latin, and Arabian writers treat of Causus in nearly the
same terms as Hippocrates, we shall be very brief in noticing their descrip-
tions.— According to Alexander, there are two varieties of Cansus, the True
and the Spurious, the former being marked by intense thirst, bilious stools, .
tongue rough and black ; and the latter, by the thirst being moderate, the i
tongue not black, and the stools consisting not of bilious matters but rather
of corrupted food. The former kind is said to be occasioned by a Bilious,
and the latter by a Pituitous humour. Aetius describes the disease in Xhm
COMMBNTART ON THB 8BC0ND BOOK. 199
same terms as our author. He says that it is produced by putrefaction of
yellow bile. Palladius says that Ardent Fevers are occasioned by an Erysi-
pelatous inflammation of the Lungs, or by the putrefaction of Bilious hn-
mours which have become immoderately heated. The Arabians describe it
exactly as the Greeks. According to Avicenna, there are two varieties of
the disease, the Bilious and the Pituitoas. The inseparable symptoms of the
disease are, he says, concealed heat, roughness, and, at last, blackness of the
tongue. There is no perspiration until after the Crisis. For the most part
the heat is not strong in the external parts, but is particularly so in the in-
ternal. Rhases states, that the Ardent Fever called /on/o-or by the Greeks
belongs to the class of Tertians, only that in the former the heat is more in-
tense, and the paroxysms do not terminate in a complete intermission of the
Febrile symptoms. The symptoms, he adds, bear a considerable resem-
blance to those of the Tertian Intermittent, but are more strongly marked.
According to Alsaharavius, the Causus, or Ardent Fever, is occasioned by
heated bile collected in the veins adjoining to the heart, stomach, or liver,
and its symptoms resemble those of Tertians, but are more intense.
From the above exposition of the opinions of the ancients regarding the
Causus, or Ardent Fever, the medical reader will readily recognise its iden-
tity widi the Bilious Remittent Fever of Sir John Pringle and other English
authors. The ingenious Dr. Robert Jackson thus describes the symptoms
of the Fever, as they were manifested in his own person during a severe at-
tack of it : — ^** It had scarcely any remission, though it was fundamentally of
the remitting type ; the anxieties at the prscordia were inexpressible; the
distress scarcely supportable ; the sensation of internal heat was great, the
external heat little, if in any degree increased ; the abdomen was collapsed
and lank ; the pulsation of the descending aorta strong and vibrating ; the
pulsation at the wrist moderate in force, perhaps weak, and not much more
frequent than natural ; the tongue was parched and stiff; and together vrith
tiiis there was an abhorrence of drink, which appeared nauseous and oppres-
sive. The sensations were uncomfortable, the sense of burning was torments
ing, yet the surface was frequently damp, and, as judged by the touch, not
hot. The desire of something moist and cool was most urgent.'' On Tever^
p. 403.
Some late writers have confounded the Causus of the ancients with Syno-
cha, or Inflammatory Fever. But, as is correctly stated by Baccius, the
Cansns was decidedly of the Continual or Remittent type, and nearly
allied to the Tertian Intermittent. — De Thermis, Hoffman remarks, that it
Seldom appears in the more temperate parts of Europe, but is very common
in Asia, Greece, and Italy ; and hence the frequent mention of it in the
Works of Hippocrates, Galen, and Aretxus. Oper, T. ii. § 2, c. 2.
Homer says that the Dog-star brings many Fevers upon unhappy mortals
(^Iliad. xxi. 31 .); and his Commentator, Eustathius, remarks that the poet cor-
rectly refers the origin of Ardent Fevers to the heat of the Dog-days.
XXX. — ON THB CURB OF ARDBNT FBYERS.
Our author's directions respecting the treatment are mostly taken from
Xiippocrates, de "Rat, Vict, Acut. Hippocrates allows venesection only
Mrhen the attack is violent. He approves of the application of cold water to
tbe surface. Archigenes, as Aetius informs us, sponged the head and chest
with cold water during the acm^ of Ardent Fevers. Lib. iii. 169. His own
treatment, which is borrowed from Philumenus and Galen, consisted of cool-
ing remedies internally and externally, such as drinking cold water and
other things of a refrigerant nature, using cold applications, and the cold
,,.co«»
500
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COMMENTARY ON THK gBCOND BOOK* 201
ovdinary cases, he approves of giving cold water to extinguish the Fever,
but says that he has seen patients brought to imminent danger by the uiv-
seasonabie application of cold cataplasms and clysters.
Aetitts states that Fevers are kindled by the parts about the bowels, liver^
and lungs, being attacked with £rysipelas. Like our author, he approves of
cold drink, cool air, and cold applications to the part affected.
The acute affection of the Vena Cava, which is minutely described by
Aretsus, ought probably to be ranked with the diseases which we are now
treating of. De Morb, Acut, iii. 8. He recommends for it venesection
and the refrigerant plan of treatment. Cur. Marb, Acut. ii. 7. We have
stated in the preceding chapter that Palladius refers one variety of Ardent
Fever to Erysipelas of the Lungs.
A similar account of these affections is given by Avicenna, lib. iv. fen. i«
tr. 4, c. 13, 14, 15 ; and by Rhases, ad Mansor.n. 15, alib\que.
I can draw no information from modern works to illustrate the opinions of
the ancients respecting the Febrile affections treated of in this chapter. It does
not seem to be suspected now that Erysipelas ever attacks the Lungs or
Bowels ; and yet, as this disease when it occurs externally is known to be seated
principsdly in the Epidermis, and as the Epithelium, or membrane which lines
the internal cavities, is admitted to be a prolongation of it (see Kaau Boer-
haave, Perspiratia Dicta Hippocrati), it would seem probable a priori^
that the diseases of both portions of it should be alike. That Fevers are
often complicated with Ardent affections of the Lungs and Bowels, and
bilious appearances, we all adroit ; and it might be worth while to inquire
whether such diseases be of an Erysipelatous nature.
XXXIL DIAGNOSIS OF HBCTIC FBVBRS.
Ou& author has copied froro Oribasius (JSynop. vi. 21.), who in his turn is
indebted to Galen. (De Diff, Feb, i. 11.) A similar account is given in
Somewhat fuller terms by Aetius, v. 92. — See also Alexander, xii. 4. We
shall merely give his explanation of the characters of the pulse. It is hard
^nd small, because the vessels have become dry and contracted; — it is
<^eDse (frequent ?) because the necessities of the system required it to be so,
(namely in order to make up for the reduced expansion of the artery) ; — it is
^eeble, owing to the weakness of the vital powers ; — and slender, because die
Vessel does not admit of being stretched in breadth. Nonnus and Actuarius
<]erive their views from Galen. Palladius states, that the Hectic is an un-
ceasing Fever, wasting and consuming the natural humidity of all the mem-
bers, and supervening for the most part upon acute and ardent Fevers, but
Sometimes arising from syinpathy with some vital organ. He states it as a
characteristic of the Hectic Fever, that food increases the febrile heat, in like
^xianner as water poured upon unslacked lime unkindles heat. This com-
parison is borrowed from Galen, and is repeated also by Alexander and
Nonnus. Palladius, like our author, represents Marasmus as the termination
of the Hectic Fever. It is distinguished, he says, by prostration of the na-
tural faculties, aridity, and wasting of the body, whicn becomes dried and
parched like a tree deprived of its juices by exposure to excessive heat.
According to Haly Abbas, Hectic Fevers commonly arise, either from the
i^onversion of Semi-tertians, or from abscesses of the lungs, whence heat is
^ent to the heart, and from it is diffused over the system. Theor, viii. 7.
•A^lsaharavius states, that Hectic Fevers arise firom protracted Ephemeral ot
Putrid Fevers, or from sympathy of the system with ulceration of the Lungs,
bladder, or Liver, or from any chronic and prolonged disease. Tract. xxxtL
A.verrhoes represents the Hectic as supervening upon Ephemeral and Putrid
202 GOMMBNTART ON THB 8BC0ND BOOK.
Fevers. He ridicules the comparison of the effects of food on the Febrile
Heat to those of water poured upon lime. Colliget. iv. 33. Avenzoar
gives the same account of Hectic as our author. Lib. iii. tr. 3. c. 13.
Serapion*s account, although borrowed from the Greeks, is distinct and
curious. Tr. vi. 11. — See also Rhases, ad Maruor, x. 3, alihique. He and
Haly Abbas repeat the graphic delineation of a person in the last stage of
Hectic Fever, borrowed by our author from Galen, who seems to have had
in view a similar description of a person sinking of consumption, given by
Aretaeus. De Morb, Chon. i. 8. Avicenna*s account of the nature and
causes of Hectic Fevers is so ample, that I regret my limits will not permit
me to do justice to it. The principal causes of them which he enumerates
are Ephemeral and Putrid Fevers, and abscesses of the Lungs and Liver.
The pulse, he says, is hard, small, frequent, and weak, and may become
myurusy if the fever pass into the state of marasmus. He gives principally
from Galen (de Marasmo) an interesting description of what he calls the
Hectic of old age, but which Galen calls old age from disease. Its symp-
toms, as described by these authors, are coldness and aridity of the body ;
the pulse slow, small, and rare, unless very weak ; the urine white, thin,
and watery. Lib. iv. fen. 1. tr. 3. Frauciscus de Pedemontio, a writer of
the fourteenth century, in like manner pronounces the Hectic of old age
to be a dry intemperament of the system, and recommends to treat it with
a cale&cicnt and moistening regimen.
XXXin. ON THB CURB OF HBCTIC FEVERS.
This chapter is taken from Oribasius, Synop. vi. 22. It will be remarked,
that our author's treatment consists of diluents and refrigerants internally,
with cold applications and baths. It is entirely derived from Galen. Galen
defends, in very strong terms, the use of the cold bath, which had been con-
demned by a celebrated physician of the name of Philip. Meth, Med, lib.
X. He admits, indeed, that an inflammatory or erysipelatous affection of a
vital organ, and a redundance of crude and putrid humours in the body, may
compel us to abstain from the bath ; but, in all other circumstances of Hectic
Fever, he insists that it is the remedium unicum. He also recommends cold
drink and cold applications to the part primarily affected. He speaks ^-
vourably also of the internal administration of renigerants, such as lettuces,
which may also be applied externally. De Marasmo, For diet, he recom-
mends articles of a diluent and cooling nature, such as ptisan, bread steeped
in cold water, and the milk of asses. Meth, Med, u, s,
Aetius, in like manner, recommends the bath, unless the use of it be con-
traindicated by the inflammation of some vital organ, or a fever enkindled
by the putrescency of the humours. He gives minute directions for the ap-
plication of the bath, the amount of which is this, that, under certain circum-
stances, it will be most prudent to use the tepid bath before the cold. In
all cases, he directs to rub the body with oil before going into the bath, and
to get it gently rubbed with towels after coming out of it. He greatly praises
the milk of asses, which he recommends to be drunk warm.
Alexander also forbids the use of the bath, when inflammation of any vital
part is present. He approves greatly of the milk of asses for food. He al-
lows wine only when the patient is of a cold and dry intemperament. I need
not go over the practice of the subsequent Greek authors, as they follow
servilely the doctrines of Galen.
According to Avicenna, the great indications of cure are dilution and re-
frigeration. To the class of refrigerant remedies, he refers barley wat^, the
milk of asses, and trochisks of camphor, with cooling epithemes and ointments.
COMMSNTART ON THX SECOND BOOK. 203
To the class of diluents he refers the bath, about the administration of which
he is Tcry particular. He directs to use ihe tepid bath at first, and gradually
bring the patient to bear the cold. When it can be borne, he says, the cold
bath should be taken immediately after the hot. He also speaks favourably
of the afiusion of tepid water. (The late Dr. Currie of Liverpool found, thai
the tepid afifusion mitigated the paroxysms of Hectic Fever. )--~See Avicenna,
lib. iv. fen. 1. tr. 3.
Haly Abbas directs, when the symptoms of consumption are fairly set in,
to administer before sun-rise trochisks containing camphor, poppies, &c. to
mitigate the cough. like most of the other authorities, he speaks favour-
ably of the milk of asses and of women for food. But, upon the whole,
his greatest dependence seems to have been upon camphor. Tr, iii. 26.
Alsaharavius directs, first to make the patient go into the warm bath,
and immediately afterwards to plunge him into the cold. Pract. tr.
xixii.
What Avenzoar most particularly recommends is the tepid bath of fresh
water, which he directs to be taken several times in the day. He speaks &-
vourably of goat*s milk. Lib. iii. tr. 1. c. 13.
Averrhoes recommends nearly the same practice; but he says that the
bath ought to be gradually applied. He approves of the milk of women,
asses, and goats, and also of refrigerant herbs. Colliget, vii. 15.
Serapion is very minute in his directions about the asses' milk. He says,
the animals should be fed upon juicy and cooling herbs, such as grow by the
side of rivers. He also directs to medicate the bath, by previously boiling-
in it refrigerant herbs, such as gourds, barley, and violets. Tr. vi. 11.
Khases* directions, although they possess, perhaps, little originality, are in
the highest degree interesting. He recommends for food fishes, cooling
herbs, such as mallows, lettuces, citrons, cucumbers, &c. and the milk of
asses or of goats. He especially commends the tepid bath, and directs to .
rub with oil afterwards. He also speaks of applying to the chest cloths
soaked in rose-water which has been cooled in snow. When these cold ap-
plications bring on shivering, he directs to have them somewhat warmed.
He forbids copious draughts of cold water. He recommends cool and
humid air, and cautions to 'avoid smoke. When the belly is constipated, he
<iirects to give opening medicines, such as prunes and manna. When, on
the other hand, the belly is loose, he recommends astringents. He particu-
larly commends trochisks of camphor, which, he says, will cool the heat of
the heart, liver, or chest. Ad Mansor, x. 3. — See also Ckmtin. lib. xxxi.
In the latter work, he informs us, that physicians were divided in opinion re-
garding the use of the bath in Hectic Fever. He forbids the cold bath and
cold drink, when the patient is much wasted, because the cold penetrates to
the vital organs and impairs them.
Baccius, the great modem authority on the use of the bath, strongly in-
sists, that in Hectic Fever it is indispensably necessary that the patient go
first into the warm bath, and then immediately after into the cold. This ac-
cords exactly with the rules laid down by Galen and the best of the ancient
authorities. De Themiis, lib. vii. c. 22. Platearius, Rogerins, and other of
the earlier modem authors, make mention of the bath for the cure of Hectic
Fever. Barzizius directs not to remain long in the bath, and to drink asses'
milk afterwards. De Balneis, p. 225.
XXXIV. — ON THB SEMI-TBRTIAN8.
The reader may find histories of the Semi-tertian in the Epidemics of
Hippocrates, where see the Commentary of Galen. Our author's account
204 COMIIBNTART ON THK SECOND BOOK.
is condensed from Galen, de Diff, Febr. ii. 2. and de Typisy c. 4.— ^See
AetiuSy V. 81. — Actuarius, Morb. l)ig, ii. 1. — Nonnus, c. 142. — Celsus, iii.
8. — Palladius, c. 21. Ceisus describes it as the second species of Tertian in
the following terms : — *' Alterum longe pemiciosius, quod tertio quidem die
revertitur, ex octo autem et quadraginta horis fere sex et triginta per ao-
cessionem occupat, interdum etiam vel minus, vel plus ; neque ex toto in
remissione desistit, sed tantum levius est. Id genus plerique medici
^furpiraiov appellant.'' He approves of bleeding at the commencement and
of a diet that is nutritive without being heating.
Palladius says, that the Semi-tertian is compounded of a Tertian inteiw
mittent and a continual Quotidian, the Quotidian paroxysm taking place
every day, and the Tertian every alternate day. He ascribes their origin to
a mixture of putrid bile and phlegm. C. 21. Haly Abbas gives a similar
account of it He calls it a Fever compounded of a Tertian and Quotidian,
and remarks that it has a tendency to pass into Hectic. He treats it with
diluents and refrigerants. Fract, iii, 17. Avicenna gives a very detailed
account of the symptoms and cure of the Semi-tertians. He remarks that
the Fever is apt to be protracted and to pass into the Hectic. Lib. iv. fen.
1 . tr. 4. — See Khases, ContinenSy lib. xxxi. All his authorities agree in
describing it as a compound of the Tertian and Quotidian, having a severe
paroxysm the one day and a slighter the following. It is said to be gene-
rally protracted to the fortieth day.
Platearius, and the other earlier modem writers, describe the Semi-tertian
in nearly the same terms as the ancients. They in general recommend bleed-
ing for Uie cure of it. The Semi-tertian is minutely described by Mr. Cl^-
horn, (Diseases of Minorcay chap, iii.) and by Hoffman, (Oper. t. ii. §. 1 . c.
5.) The latter does not in general recommend venesection, and trusts prin-
cipally to gentle purgatives and diaphoretics.
XXXV. — ON EPIDEMIC DISEASES.
This chapter is mostly taken from Oribasius, Sj/nops, vi. 24. and Euporist.
c. 1.
The works of Hippocrates contain many interesting remarks on the origin
and nature of Epidemics. He states that diseases in general may be said
to arise either from the food we eat or the air we breathe. When, therefore,
a disease seizes on a multitude of persons of different ages, sexes, and habits,
he justly infers that it must arise from the latter cause. See de FUttibta^
Epidem. cum Commentariis Galeni, It is reported of Hippocrates, that, like.
Acron of Agrigentum, he changed the morbific state ot the atmosphere at
Athens by kindling fires. (Galenus, Therap. ad Fison. — Aetius, v. 94.) — •
Acron*s method of purifying the atmosphere is mentioned by Plutarch, de
hide et Osiride. For an account of Acron, see Fabricii Biblioth, Grac.
tr. xiii. p. 32. — Conringii Introduct, and Mangeti BibL Med, Pliny says
of Fire as a corrective of the state of the atmosphere — '' Est et ipsis ignibos
medica vis. Pestilentiae, qus solis obscuratione contrahitur, ignis suffitu
multiformiter auxiliari certum est. Empedocles et Hippocrates id demon-
stravere diversis locis.'' H. N. xxxvi. 69. With the same intention, Simeon
Seth proposes fumigations with frankincense. The historian, Herodian, re-
lates, that fumigations with aromatics were recommended as a preventive of
the Plague. Lib. i. The merits of the Hippocratic method of purification are
amply and candidly discussed by Van Swieten. — Comment, in Boerh.Aph,
§ 1407. Paulinus properly directs to regulate it by the season of the year
and other circumstances. Fralect. Marc. p. 393. It did not answer in the
Plague of London, A.D. 1666.
COMMBNTART ON THE SKCONB BOOK. 205
Galen, in like manner, attributes the origin of Epidemics to the state of
the atmosphere in a great measure, but also holds that the nature of the
country may contribute ; as, for example, its vicinity to a gulf like the Cha»
ronian, from which miasmata are exhaled that taint the air and occasion dis-
eases. In many passages of his Commentary on the Epidemics of Hippo-
crates, be states that Epidemical diseases arise from the condition ot the
country in which they prevail. It will be recollected that our Sydenham
advanced a similar doctrine. He says, *' And thus it happens, that there
are many constitutions of years that arise neither from heat nor cold, nor
moisture nor drought, but proceed from a secret and inexplicable alteration
in the bowels of the earth, whereby the air is contaminated with such effluvia
as dispose bodies to this or that disease as long as the constitution prevails,
which, at length, in a certain space of time, withdraws and gives way to an-
other." This theory, although I have seen it much ridiculed of late, seems to
me very plausible. The philosophical poet, Lucretius, accounts for the pre-
valence of Epidemical diseases upon similar prrociples : —
'' Atqne ea vis omnis morbomm, pestilitasque,
Aat extrinsicus, at nubes nebulseque supeme
Per codtun veniunt, aut ipsft sspe coorta
I Dtf terrd gurmmtt nbi potrorem htunida nacta est,
IntempestiviB pluviisque, et solibos icta."
DeRerum Natvra, Lib. vl. 1100.
Syllius Italicus appears to refer an Epidemical Fever to the same cause.
Lib. xiv.
If we reject this theory of the origin of Epidemics, I do not see how we
can account for the Malarious prevailing in certain districts of Italy, nay, iii
Certain streets of the city of Rome, while the surrounding country is wholly
exempt from its ravages. But we must return to our exposition of the doc-
trines of Galen. In his work on the Varieties of Fever ^ he expresses his opi-
nions on this subject very fully. He remarks, that an atmosphere of a hot
constitution, such as generally prevails at the time of the rising of the Dog-
star, having been inhaled by the heart, increases the heat in it, from which it
is diffused all over the system, and enkindles a Febrile affection. lu pesti-
lential constitutions, he adds, it is principally by the respiration that the dis-
ease is contracted, although sometimes it may arise from the fluids of the
body being disposed to putrescency, which is increased by the condition of
the atmosphere ; but for the most part Epidemical complaints derive their
origin from the atmosphere being tainted with putrid exhalations. The pu-
tridity of the atmosphere may be occasioned either by a multitude of dead
bodies which have not been burnt, as is apt to happen in wars, or it may
^rise from the exhalations of certain marshes or lakes in the summer season,
or sometimes the inordinate heat of the atmosphere may give rise to them, as
bappened in the case of the Athenian plague, according to the testimony of
"Thucydides. And here again I must digress to remark, that Homer evidently
Ascribes the plague which attacked the Grecian army to the great heat of the
sun. — (See the Commentary of Eustathius on the beginning of the Iliad, Am-
mianus Marcellinus, lib. xix., Heraclides Ponticus, Allegor., and Macrobius,
Sutumaliay vii. 5.) Galen, however, inculcates that the constitution of the
atmosphere alone is not sufficient to produce disease without a peculiar dis-
position of the body to admit it ; for that, otherwise, all without exception
^would be seized with the prevailing epidemic. This leads him to give di-
rections to correct the intemperament of the body when it is such as disposes
it to be readily affected by the constitution of the atmosphere. His directions
^re similar to those of our author. Besides tlie causes of Epidemical dis-
eases which we have mentioned, he states that unwholesome food and drink
may sometimes, though rarely, give rise to them. Of this he relates a striking
206 COMMENTARY ON THE SECOND BOOK.
instance. De Rebu$ Boni et Mali Succi^ c, 1. He remarks, that the most com-
mon Epidemical diseases are Pestilential Fevers. We shall have occasion
to state his opinion of them in the next chapter.
Of the Greek authors posterior to Galen, Oribasius and Aetius give tlie
same account!of Epidemical diseases as our author ; and the others either do
not treat of them at all, or class them with the subject of our next chapter.
Avenzoar has given us a separate treatise on Epidemical complaints. The
first cause of them which he mentions is a humid and warm state of the at-
mosphere, such as that to which Hippocrates ascribed the Pestilence which
afflicted Thason in his time. {Epidem, iii.) The other causes enumerated by
him are, the effluvia from dead bodies, stagnant air, the miasmata from stag-
nant and corrupted waters, and unwholesome food. Lib. iii. tr. 3. c. 1.
On the origin of Epidemical diseases, especially the Pestilence, see, in par-
ticular, Haly Abbas, Theor. v. 1 1 . The principal causes of the change of the
atmosphere to a pestilential state, according to Haly, are the nature of the
country and the season of the year. The former cause operates owing to the
putrid effluvia arising from corrupted fruit, pot-herbs, &c. or the miasmata
from marshes, cloacs, or dead bodies, whether of men or cattle. It was from
such causes, he remarks, that the Plague of Athens derived its origin. The
nature of the season, as it produces diseases in the vegetable, so does it also
in the animal creation. As Epidemical complaints, he mentions Ephemerals,
Cynanche, Small-pox, Acute Fevers, and other fatal diseases.
Avicenna's account of the origin of Pestilential and Epidemic diseases is
taken almost entirely from Galen ; he therefore enumerates as causes of them
a humid and warm state of the atmosphere, the stagnant air of caverns, the
miasmata of lakes and marshes, and the effluvia from dead bodies. Lib. iv.
fen.i.tr.4. Alsaharavius enumerates exactly the same causes. Tr. 32. Rhases'
account is mostly taken from Hippocrates and Galen. Contin, lib. xxx.
The Latin historian, Ammianus Marcellinus, gives an ingenious disquisi-
tion on the origin of these diseases ; but the distinction which he endeavours
to establish in the following passage is not acknowledged by the medical
authors in general : — << Prima species luis Pandemus appellatur, quae efficit
in aridioribus locis agentes caloribus crebris interpellari ; secunda, Epidemus,
quee tempore ingruens acies hebetat luminum, et concitat periculosos humores ;
tertia, Lamodes, quae itidem temporaria est, sed volucri velocitate letabilis.'' —
Lib. xix. c. 4. The causes of these complaints, as enumerated by him, are,
excessive heat, cold, drought, or moisture, effluvia from putrid bodies, and
exhalations from the earth.
According to Diodorus Siculus, the causes which gave rise to the Pesti-
lential Epidemic which attacked the Carthaginian army in Sicily were, the
marshy nature of the country in which they were encamped, the bodies of
the dead lying unburied, and the excessive heat of the season. Lib. xiv. He
ascribes the Plague of Athens to similar causes. Lib. xii. 58.
XXXVL ON THE PLAGUE.
By the Plague, as Galen explains, in his Commentary on Hippocrates, is
to be understood an Epidemical Fever of a fatal nature. Hippocrates has
related several histories of diseases which come under this description, in his
Epideviics, but they present such variety of symptoms, that I cannot under*
take to give their general characters. I shall, therefore, begin my exposi-
tion of the ancient opinions regarding the Plague, with a brief notice of the
celebrated description of it given by Thucydides, the Greek historian, with
which the cases related by Hippocrates agree very well on the main. The
more prominent symptoms mentioned by him are the following : — Strong
COMMENTARY ON THB SECOND BOOK. 207
beat of the head, redness and inflammation of the eyes ; the mouth and inter-
nal fauces turgid with blood, breath fetid ; sneezing, hoarseness, and after-
wards violent cough, vomiting of bile, singultus, and convulsions ; the heat
of skin not much increased, but the internal parts glowing with heat; the
skin reddish, or livid, and covered with minute phlyctsne and ulcers; de-
spondency, restlessness, and intense thirst ; and, towards the conclusion,
diarrhcea, ulceration of the bowels, and various symptoms of putrefaction.
Those who survived the Febrile attack were subject to blindness, fatuity, ami
mortification of the testicles and extremities. The disease generally proved
fdiaX on the ninth or seventh day. The historian affirms that the plague never
attacked the same penon more than once. This opinion has been advocated
in modem times by Massarius, Diomedes Amicus, Heumius, and Sir Wil-
liam Pym, but general experience seems to be against it. Evagrius relates
of the plague which prevailed in the reign of Justinian, that many persons
who recovered from the first attack sunk under a second. Ficinus, Montisi-
anus, Joubertus, and many late authorities, hold this opinion. Thucydides'
celebrated description of the Plague is given in a poetical form by Lucretius,
de Remm Natwa, apudfineniy and by Ovid, Metamorphoseon lib. vii. 1.528.
Sophocles, the tragedian, appears also to have had it in view. Oedip, Tyram,
ap. initium. The Latin poet, Silius Italicus, evidently copies his images from
it. Lib. xiv. See also Lucanus, Fhartul. lib. vi. and Manilius, A$tronom,
lib. i.
Our next great authority on this subject is Celsus. In his account of the
Plague, weJiave to regret however, that, although he dwells rather minutely on
the Prophylaxis and Treatment, he has omitted to give us a description of the
disease; and it is not easy to perceive the principles upon which some of
his directions as to the Prophylaxis are given. He recommends a journey to
a distant place, or a sea voyage; when this cannot be accomplished, gesta-
tion and gentle exercise in the open air, but he forbids all excess. He also
Ibrbids early rising, exercise with naked feet after a meal or the bath, also
emetics, laxatives, and sudorifics. He directs to drink, by turns, first water
stnd then wine. Lib. i. c. 10. It would appear to have been his wish that all
depletion should be avoided, lest, by emptying the vessels, absorption should
be accelerated. With regard to the Treatment, he disapproves, in general, of
abstinence and purgative medicines, recommends bleeding, if the strength
permit, more especially if the Fever be attended with pain ; but, if veneseo-
lion cannot be practised, he directs to give Emetics. At an earlier period
than in ordinary £evers, the patient is to be put into the bath, and is after-
^vards to get hot undiluted wine, and every thing of a glutinous nature, and
flesh of this description. In the case of young persons, he directs to admi-
nister these remedies with great caution. Lib. iii. c. 7.
The historian Appian, Lucian, and Plutarch, mention wine as an antidote
to the Plague. Livy and other ancient writers say that the Plague is some-
times occasioned by excessive cold. Histor. lib. v.
It is greatly to be regretted that Galen has given us no description of the
dreadful Plague which prevailed in his time. It appears that he fled from
Home for fear of infection. lie alludes to it, indeed, in several parts of his
works, but in very brief terras, only mentioning that it put on the appear-
ance of Dysentery ; and in one place he strongly commends the celebrated
Tberiac as a most efficacious remedy for the prevention and cure of Pestilen-
tial disorders. Of the writers on medicine posterior to him, Oribasius and
Aetius, like our author, give no further information on this important subject
than what is contained in the brief extract from the works of Ruffus ; — and
the others, with the exception of Nonnus and Psellus, do not treat of the dis-
ease at all, unless in an incidental manner. Nonnus, after briefly stating the
causes of the Plague, proceeds to lay down the principles for conducting the
208 COMMENTARY ON THB SBCONO BOOK.
treatment. He recommends clysters, and, if the stomach be loaded wHh
phlegm, emetics : if there be a fulness of blood, he approves of venesection ;
and also speaks well of giving diuretics. When symptoms of ardent fever
are present, he directs to give cold drink freely, in order to extinguish the
Febrile heat. He also recommends apomel, the water of ptisan with the seed
of bastard saffron, or Armenian bole, or lapis lazuli. Psellus merely men-
tions, in very general terms, a few of the common symptoms of the Plague.
Opus Medicum.
Before proceeding to the Arabian authorities, I shall give a brief ab-
stract of Procopius* description of the dreadful Plague which desolated the
Roman Empire in the reign of Justinian. Its usual precursors were certain
delirious phantasies and disturbed dreams, after which the fever made its at-
tack suddenly. The early symptoms, however, ware not well marked, for
there was neither increased heat nor discoloration of the skin, nor did the pa-
tient apprehend danger. Generally on the first or second day, but in a tevr
instances somewhat later, buboes appeared not only in the groin but also in
the arm-pits and below the ears. S<Ane were affected with deep coma, and
others with wild delirium. Some died from sphacelus of the buboes, which,
when inspected by the physicians after death, presented the appearance of a
coal or carbuncle (anthrax.) Some died at the commencement, and others
after the lapse of several days. In certain cases the skin was covered over
with black phiyctaenae of the size of a lentil, which were usually succeeded by
sudden death. Others were unexpectedly cut off by a discharge of blood.
To women in the puerperal state it proved particularly fatal. When the
buboes came to a proper suppuration, they generally proved a favourable
crisis, but when they did not suppurate they were commonly followed by a
wasting of the thigh. One of the common consequences of the fever was an
affection of the organs of speech. All the usual prognostics proved fallacious,
and the effects of the common remedies were uncertain. In some cases the
bath proved beneficial, and in others it had a contrary effect. At one time
the amount of deaths in Constantinople ranged from five to ten thousand each
day. This Pestilence is described likewise by Agathias, lib. v. and by £va-
grius. It resembled the Plague of Avignon, described by Guy of Cauliac.
The symptoms of the plague, as enumerated by Avicenna, are as follows: —
Heat, and strong inflammation within, but which are not perceived out-
wardly; respiration large, fetid, and frequent, intense thirst, dryness of the
tongue, with nausea and loss of appetite, such as if not contended against
will prove fatal ; enlarged spleen, great anxiety and restlessness, dry cough,
prostration of the powers approaching to syncope; delirium, retraction of
the hypochondria, insoranolency, with tepid heat of the body. Sometimes
there are yellow, whitish, or red eruptions on the skin which are of short
continuance ; or else aphthae and ulcers in the mouth. The pulse is gene^
rally frequent, small, and becomes stronger towards night. Occasionally
there are dropsical swellings. The discharges from the bowels are bilious,
mixed, fetid, unnatural, and sometimes contain black bile; at other times they
are frothy and fetid, or unctuous, being produced by melting of the fat. The
urine is watery, bilious, and melanchulic. There is sometimes vomiting of
black, but more frequently, of yellow bile. There are often fetid sweats.
The disease usually terminates with syncope, coldness of the extremities,
lethargy, spasms and convulsions. Some of the most fatal varieties of the
plague are not marked by any striking symptoms, neither the heat, pulse, nor
urme being much affected. Fetid breath, as indicating putrefaction about
the heart, is a most mortal symptom. The treatment must commence with ve-
nesection, if there be a plethora of blood, or with purging, if the body be loaded
with other humours. The apartments of the sick are to be cooled, and the
air of them corrected : they are to be cooled by cold odoriferous fruits,
COMMBNTAKT ON THE 8BC0NO BOOK. 209
camphor, rose-water, or, if possible, by introducing a stream of water into
them. The fetid air may be corrected by fumigations with camphor, myrtles,
quinces, ebony, &c. by sprinkling the apartments with vinegar and assa-
fcetida, and correcting the putridity with lignum aloes, frankincense, musk,
storax, sandarach, mastich, juniper, bays, and the like. (It may be proper to
mention, that arsenical fumigations are approved of by Muratori, Lind, and
Russel, but Condemned by Mead.) As a preservative from the Plague, he
recommends, in particular, exercise and restricted diet, llaly evidently
copies liis description. Theor. v. 1 1 .
kluises agrees with Hippocrates in stating, that Pestilential Fevers are dis-
tinguished by great heat internally, while the surface of the body is cool.
The symptoms, as detailed by him, are, vomiting and diarrhoea, pain and
distension of the belly, coldness of the extremities, urine showing a tendency
to putrefaction, discharge of blood from the nose, heat about the breast,
singultus tendinum, blackness of the tongue, bulimia, &c. He particularly
states, that a black discharge from the bowels is a most fatal symptom. Like
Avicenna, he gives directions to perform fumigations with camphor, musk,
myrrh, bdellium, frankincense, and the like. He mentions that, dur-
ing the prevalence of a certain pestilence, it was found that hunters escaped
the contagion. Like Avicenna, he approves of blood-letting — (See Continetvt,
lib. XXX.) He also recommends cold drink and the cold bath. Calefacients
and wine, unless diluted with much cold water, he disapproves of. Ad MaU'
ior, iv. 25.
While explaining the symptoms and treatment of the Plague, as detailed
in the works of the ancient authors, I have purposely omitted to notice its
contagious nature, as I wished to give one connected view of the ancient
opinions regarding Contagiok. Before entering upon this disquisition, I
think it proper to acknowledge the assistance which I have derived from the
writings of Fracastorius, Paulinus, Mead, Marx, Omodei, and Winterbottom,
leaving it to the reader to determine, after comparing my humble attempt
with their learned labours, whether or not my industry and research have
contributed in any wise to throw additional light upon this important sub-
ject.
The earlier ancient authors appear to have entertained no suspicions of
Contagion as a cause of Febrile, or of other complaints. Homer, as formerly
stated, evidently refers the origin of the Plague which prevailed in Uie
Grecian army during the siege of Troy to the heat of the sun. The works
of the Fathers of History and of Medicine have likewise been ransacked in
vain, for any traces of the doctrine of Contagion. Tfmcydides, therefore,
appears to be the first author (if we except the Mosaic description of Leprosy)
yi\io makes any positive allusion to the contagious nature of diseases. From
his description of the Plague of Athens, there can be no doubt that he
wishes it to be understood, that the disease was transmitted from one person
to another ; for he mentions that physicians were more attacked by it than
any others, as having most intercourse with tlie sick ; and he afterwards
describes the terror which the citizens felt to approach those labouring under
the disease, and intimates that it was often contracted by such intercourse^
The language of Lucretius, who copies his description, and gives it a poetical
form, is still more precise : —
li
nullo cessabant tempore apisc
Ex aliis alios avid! contagia morbi.'*
L. 1236.
And afterwards, —
*' Qui fderant autem prsesto contagibus ibant.**
L. 1241.
210 COMMSNTART ON TH8 SECOND BOOX«
Ovid, in like manner, says of the dead bodies :-«
** Afflatuque nocent et agont oontagia latd."
Metam, lib. y. 551.
And so also, Silius Italicus : —
<* Et posnere avidae mortis contagia pestes."
lAb. xiy.
The historians we must dismiss in a few words, with stating that allusions
to the infectious nature of certain diseases are to be met with in Livy, Dio-
nysius the Ualicamassian, Diodorus Siculus, Appiao, Plutarch, Qnintus
Curtius, Dio Cassius, Eusebius, Gregory of Nyssa, and Evagrius. Procopius
was a non-contagionist.
The philosopher Aristotle, in one of his Problems, makes it a question
why the Plague is the only disease which infects those who approach the
sick. Probl. §. 1 . The Elder Pliny mentions the contagion of the Pesti-
lence.
Virgil mentions the infectious nature of certain diseases of cattle. Eel. i.
Georg, iii. 464. The ancient writers on Veterinary Surgery and Agricul-
ture, in like manner state that the Plague and Scabies m cattle are infec-
tious.— See Columella, vi. 5. Vegetius, Mulomed. iii. 23.
The philosopher Marcus Antoninus, alludes to the Plague as being con-
tagious. Lib. ix. §. 2. Chrysostom does the same. In Joan, Orat, Itii.
The language of Seneca is very precise : — " Itaque ut in pestilentid, caven-
dum est ne corruptis jam corporibus et morbo flagrantibus assideamus, quia
pericula trahemus, afflatuque ipso laborabimus." — De Tranquil, c. vii. To
these we may join Isidorus Hispalensis, a much later writer : — *^ Pestilen-
tia est contagium quOd quum unum apprehenderit celeriter ad plures
transit.'' And, in another place : — '* Pestilentia est morbus latb vagans et
contagio suo quae contigerit interimens.'' — ^Alexander Aphrodisieus intimates
that Pestilential Fevers are contagious, but Common Fevers not so. ProbL
ii. 42.
Aretseus appears to be the first medical author who alludes to Contagion in
unequivocal terms. He says of Elephantiasis, that it is as infectious as the
Plague, being communicated by respiration. Coelius Aurelianus, who was
probably nearly cotemporary with him, mentions as contagious diseases the
Plague, Incubus, Hydrophobia, and Elephantiasis. Gralen expresses his
sentiments on the Contagious nature of certain diseases in the following
terms ; — " That a Pestilential state of the atmosphere produces Fever, is un-
known to no one possessed of good understanding ; and, also, that it is
dangerous to associate with persons having the Plague, for there is a risk
of catching it, like the Itch and Ophthalmy. It is dangerous also to live
with those labouring under Consumption, and, in a word, with all those hav-
ing a putrid respiration of such a nature as to render the houses in which they
lie fetid.*' De Diff, Febr. i. 3. — Aetius (lib. xiii. 120.), and our author
(lib. iv. i.) state their decided opinion of the infectious nature of the Plague
and Elephantiasis. Oribasius, Alexander, Synesius, Palladius, Actuarius,
and all the Latin Medical authors, with the exception of Coelius Aurelianus,
have omitted to make any allusion to the Contagious nature of diseases.
Of the Arabians, Khases mentions, as diseases " which are transmitted
from one person to another,'' Lepra (Elephantiasis ?), Itch, Consumption,
and Pestilential Fever. These, he says, prove infectious, when one is shut
up in a narrow house along with those labouring under them, or when one
sits in the wind blowing from them. He states afterwards, that Ophthalmy
and malignant Pustules are sometimes contagious. Ad Mansor. iv. 24. —
See also Contin. lib. xxxiii. tr. 5. By malignant Pustules he means the
COMMENT ART ON THK 8BC0ND BOOK. 211
Small Pox. Avicenoa and Haly Abbas give the same list of Contagious
diseases. Avicenna says that Small Pox and Measles are 'of all diseases the
most contagious. Of the other Arabians, Avenzoar alone, while treating of
Elephantiasis, alludes to the doctrine of Contagion.
naving now done with the ancient authorities, I shall only give further
the declaration of the celebrated Boccacio regaixling the Plague of Florence :
— '* £ fu questa pestilenza di maggior forza, percio che essa dagF infermi di
quella per io communicare insieme s' avventava a' sani non altramenti che
faccia il fuoco alle cose secclie o unte, quando molto gli sono avvicinate.*'—
Decameron^ Introduzione,
The result of my investigations into the opinions of the ancients on this
subject leads me to the conclusion, that all, or at least the most intelligent
of the medical authorities, held that the Plague is communicated, not by any
specific virus, but in consequence of the atmosphere around the sick being
contaminated with pntrid effluvia. Hence, they maintained, that mild
fevers (jTvmjB^is) which show no tendency to putrescency, are not communi*
cable from one person to another. — (See Alexander Aphrodisieus, u. s.) It
would appear, therefore, that their sentiments agreed pretty much with those of
the more moderate Macleanites of the present day, who admit that the Plague
is Contaminative, allthough not, properly speaking, Contagious. — (See Tkc
Westmimter Remewy No. vi. Art. 10.) Fracastorius, in like manner, consi-
dered putrefaction as the source of all Contagion (X)e Contag. lib. i.); and
nearly the same opinion was maintained by the learned Fernel, and Fran-
ciscus de Pedemont, Ingrassias, Ficinus, and others. V. Fralect. Mar, p.
77. Although Galen several times speaks of a poison being formed in the
human body, he means that the animal fluids are so altered as to become
deleterioos, and does not bold that there is any specific virus transmitted
iirom one person to another. De Lac. Affect* v. 7. vi. 5. Epidcm, iii.
Cent. r.
XXXVII. ON FEYSRS COMPLICATED WITH SYNCOPE OCCASIONED
BY THICK HUMOURS.
This chapter is taken either from Oribasius, Sj/nop. vi. 27, or Aetius, v.
97. These authors, however, merely abridge the account of this subject
which is g^ven by Galen. Meth. Med. xii. 5, and Therap. ad Glauc. lib, i.
Syncope, according to the explanation of Galen, is a sudden prostration of the
vital powers, without suspension of the respiration, as in deliquium animu
Our author has given a very correct account of Galen's treatment. He states
that, the system labouring under a load, the great indication is evacuation,
but that venesection cannot be borne in such cases. In short, he insists
that our great dependence must be placed on friction, for the application
of whidi he gives very excellent directions. When the pulse suddenly sinks
and becomes irregular, he directs to administer wine, unless there be inflam-
mation of the stomach or liver. In cases complicated with crude humours,
he pronounces the bath to be most prejudicial, and also disapproves of very
cold or very warm air. He is most particular in his directions for the selec-
tion of the most proper wine to be used, and gives some interesting observa-
tions on the principal Greek and Roman wines used in his time. He con-
cludes his remarks with stating that thick wines ought to be avoided as in-
jurious, and such as are watery and thin, as ineflectual, whereas those of a
middling kind are to be selected. He particularly praises the Arvisian and the
Lesbian. The Falemian he condemns, as being too fragrant and austere,
vrhich qualities render it injurious to the head.
Alexander disagrees with Galen as to several of the points of treatment
p2
212 COMMBNTART ON THE SBCOND BOOK.
laid down by him. He insists that Galen*s rigid rules for applying strong
friction, at the same time that abstinence is enjoined, are such as no ordinary
powers of constitution could bear up under; and, therefore, he recommends
to rub first, and then to give some light nourishment, such as thin ptisan,
oxymel, and bread soaked in wine, when the strength is greatly overpowered.
Nay, when the powers of the constitution are in danger of sinking under the
weight of the load, he suggests the propriety of having recourse to venesec-
tion ; and accounts for the benefit derived from this evacuation, upon the
same principle that a fire which is like to be extinguished by an excessive
load of green fiiel burns brighter when part is taken off. This is an in-
genious explanation of the manner in which bleeding proves useful in cases
of Congestive Fevers. Respecting the use of wine and the bath, his views are
similar to those of Galen. He approves very much of administering a light-
coloured diffusible wine, when the powers of the system ai*e much sunk.
Avicenna adheres closely to the principles of treatment laid down by
Galen ; and, therefore, says nothing of venesection. Lib. iv. fen. 1 . tr. 2l
c. 58. Rhases treats this complication of Fever in like manner. He calls it
** Febris syncoptica, ex humorum copi& et cruditate nata.'' Ad Mansor, x.
14. He mentions Emetics, but approves most particularly of Friction.-
Continens, lib. xxx.
Averrhoes contends that, in such a case, it is lawful for a Mussulman to
drink wine, although forbidden by the Prophet. He approves also of Fric-
tion. CoUiget. vii. 16.
Prosper Alpinus informs us that the Methodists, in such cases, gave wine
and aromatics, and used every means to rouse the system. Med, Method,
vi. 9.
Dr. Robert Jackson describes a variety of Fever occurring in warm
climates, which appears to have been very similar to the Febrile state treated
of in this chapter. He represents it as being distinguished by a particular
dullness, sluggishness, obscure weak pulse, nausea, and deep respiration.
Like Alexander, he approves of bleeding, which he directs to be performed
with the extremities immersed in hot water ; and they are afterwards to be
scrubbed with stimulant applications. — On Fever , p. 193. Having too often
had occasion to lament the inefficacy of the treatment usually followed in
such cases, I cannot but think that the plan recommended by Alexander
and Dr. Jackson, is well deserving of a trial.
XXXVIIL ON SYNCOPE PROM THIN HUMOURS.
This is taken from Galen. Meth. Med, xii. 6. — See also Oribasius,
Synop. vi. 27. Aetius, v. 98. In this case, Alexander recommends nearlv
the same plan of treatment as Galen. He recommends for food things which
are incrassant and anti-discutient, such as the juice of halica, succory, let-
tuces, apples, pomegranates, pears, &c. They must be administered, how-
ever, in small quantities. He approves of giving a weak watery wine, not
very old. He recommends friction with tonic and incmssant oils, such as
the oil of apples, and other applications of a like nature.
Avicenna, Averrhoes, and Rhases, treat the case exactly as our author.
XXXIX. ON THE OTHER CAUSES OP SYNCOPE.
See, in like manner, Galen. Meth, Med. xii. 7. — ^Oribasius, Synop, fi.
28.— Aetius, v. 99.
COMMBNTART ON THE 8KC0ND BOOK* 218
XL, — ON PAIN.
This chapter is taken from Oribasius, Synup. vi. 29, or Aetius, v. 100.
All these authors, however, merely abridge the account given by Galen.
Meth, Med, xii. 8, and de Locis Affect, lib. ii. In the latter work, he gives
a most ingenious dissertation on the different kinds of pain, and the states of
the body in which they occur; but, as our author has given a summary of
his observations, I think it unnecessary for me to go over the same ground.
I shall, therefore, merely notice some of his remarks on the treatment, as de-
livered in the other work. When the pain is connected with flatulence, it is
to be removed by food, drink, cataplasms, and fomentations of an attenuant
nature. When pungent humours are the cause of the pain, they are to be
treated by evacuants, diluents, or narcotics. When occasioned by thick and
viscid humours, he forbids to give narcotics, the action of which, being frigo*
rific, renders them thicker, and the containing parts more compact. In all
such cases, therefore, he holds that opium and hyoscyamus, although they
afford a temporary relief from pain, act prejudicially. lie also directs to
avoid things of a very hot nature, both internally and externally, and recom-
mends to give attenuants, or tilings of an incisive nature. He, m particular,
commends Garlic, which he calls the Theriac of rustics. As to external ap^
plications, he directs, in Febrile cases, to use first a dry fomentation of millet
seeds, and, if it is not successful, to apply friction with subtile or attenuant
oils, and the fat of fowls.
Aetius defines pain to be a sensation produced by a sudden change of
temperament, or a solution of continuity. In illustration of the former
cause, he remarks that sUl sudden changes from heat to cold, or vice versa, oc-
casion severe pains. To the latter he refers rupture, contusion, and erosion
of the parts. Kupture is produced by tension, contusion by weight, and
erosion by some pungent quality. These causes of pain ought to be particiH
larly attended to, and the treatment modified accordmgly. His subsequent
account is exactly the same as our author*s.
The different kinds of pain are fully treated of by Avicenna, lib. i. fen.
^- doct. 3. c. 20, and by Ilaly Abbas, TIteor. vi. 16. Averrhoes has de->
^'^ered the treatment of this complication of Fever, in nearly the same
^rms as Galen. When the pain is occasioned by warm air or fiatulence, he
Particularly commends cupping applied with great heat. He agrees witli
^'^len in condemning narcotics, when the exciting cause is of a cold nature.
^e also joins him in condemning hot fomentations and clysters, when the
P^in of the bowels is occasioned by a hot humour. CoUiget, vii. 18. — See
Phases, Cont, xxxiii.
X^or an account of the ancient opinions on this subject, the reader is re-
ferred to Prosper Alpinus, de l^nes. Vita et Morte Ajgrot. lib. ii. 18.
XLI. ON COLLIQUATIVB DIARRU(£A, OR MBLTING.
Galen mentions that a colliquative discharge from the bowels was a cora-
'^^ii symptom of the fatal Plague which prevailed in his time. He adds,
JtJ^t: the faces were generally of a deep yellow colour, and always fietid.
.^^nment, in Hippocrat. Epidem. lib. iii. In another place, he states that
^i^is a fatal practice to bleed or purge in cases of Fever complicated with
^i^rrhcea. Therap, ad Glauc. lib. i.
Our author borrows from Oribasius, Si/nop, vi. 30, or Aetius, v. 91 .
The Arabians direct to treat Febrile melting upon general principles, as
^^^lained under the head of Diarrhoea.
214 COMMENTARY ON THK SBCOND BOOK.
Although cold applications for the Colliquative Diarrhaa of Fever are not
now generally approved of, we are informed by Dr. Robert Jackson, that he
had found them highly beneficial in such cases. — On Fever. — See Book iii.
c. 42.
On the Colliquative Diarrhcea in Fevers — see, further, Prosper Alpinus,
de Pras. Vita et Morte jEgrot. lib. vii. 11, and Fabii Paulini Fralect.
Marc. p. 343.
XLII. ON WATCHFULNS8S IN FEYBRS.
We are informed by Cetsus, that Asclepiades trusted almost entirely to
gentle friction in such cases. Lib. iii. c. 18.
Our author, as usual, copies freely from Oribasius. — See iSywop. vi. 3t.
Nearly the same directions are given by Aetius. Lib. v. c. 116. Those in
the beginning of the chapter are from Galen ; the remaining part is from
Herodotus and Philumenus.
Nonnus gives a correct account of the established rules of treatment m
such cases. Thus, he directs to use ligatures, and apply friction, to the ex-
tremities ; and, if this treatment have not the desired effect, to have recourse
to soporific decoctions, or liniments prepared with poppies, opium, mandra-
gora, &c. or even to give internally an infusion of poppy heads. Epitome^
c. 145.
The directions given by Avicenna are so like oiir author's that we mast
suppose them copied from him. He directs first to try the effect of fatiguing
the patient, by talking loud to him, placing many candles in his chamber,
and applying ligatures to his extremities. When this method does not suc-
ceed, he recommends the soporific applications mentioned by our author.
When there is nothing to forbid the use of it, he permits to give the syrup of
poppies. Lib. iv. fen. i. tr. 2. c. 20. Haly Abbas likewise recommends
poppies externally and internally. Tract, iii. 23. Averrhoes briefly directs
to use food and applications of a soporific nature. Colliget. yi\. 2. Rhases
mentions our author's plan of treatment, and further seems to approve of
liniments made of mandragora, opium, henbane, and the juice of lettuces. —
Cont. lib. xxxi.
Coelius Aurelianus remarks, that the indiscreet use of soporifics may bring
on lethargy. According to Prosper Alpinus, the Methodists approved of fo-
mentations, consisting of soporific medicines, such as lettuces, opium, and
the like. Med. Meth. vi. 8.
Sydenham and Van Swieten agree in condemning the early use of Nar-
cotics.
The earlier of the modem writers on Medicine direct to apply to the nose
a sponge soaked in a soporific liniment prepared from opium, henbane, man-
drake, cicuta, lettuce, and the like. — See Theodoricus, lib. iii. c. 8.
XLIIL — ON CATAPHORA, OR SOMNOLENCT.
The treatment mentioned by our author is recommended by almost all the
other authorities both before and afler his time. — See, in particular, Oribasius,
Syn, vi. 33. — Aetius, v. 117. — Nonnus, Epitome^ c. 146. — Avicenna, lib. iv.
fen. 1. tr. 2. c. 18. — Haly Abbas, Pract. iii. 23.
Prosper Alpinus gives an excellent account of the practice of the Metho-
dists. It consisted of painful friction, tight ligatures, rubefacients applied to
the extremities or head, sternutatories, and, in short, every thing calculated
to rouse. Med. Mcth. vi. 7.
COMMENT ART ON THB SECOND BOOK. 215
Somnolency, or a Coroatous disposition, is a common symptom of Pesti-
lential Fevers. — See Russel on the PlaguCf p. 83, and Assalini, Observatiom
on the Plague, p. 34.
XLIV. ON HEADACH IN FEVERS.
Part of the directions delivered by Celsus for the treatment of headach
deserves to be given in his own language : — ^ Si capitis doiores sunt, rosam
cum aceto miscere oportet, et in id ingerere : deinde habere duo pittacia,-
quse frontis latitudinem longitudiuemque squent : ex his invicem alteram
in aceto et ros& habere, alterum in fronte ; aut intinctam iisdem lanam suo-
cidam imponere. Si acetum offendit pur& rosH uterdum est, si rosa ipsa
Isedit, oleo acerbo.'" If this does not succeed, he directs to use other more
refrigerant applications prepared with iris, poppies, ceruse, litharge, &c. —
Lib. iii. c 10. p. 112. Ed, MUligan.
When headach occurs towards the beginning of Fever, Galen directs to>
bleed once and again, if there be nothing to contra-indicate depletion, and
more especially if the patient be plethoric. He then directs to attend
whether it arise from fumes proceeding from the stomach, or constipa-
tion of the bowelsy and to correct these conditions accordingly. If it make
its attack after the seventh day^ he recommends first to evacuate the bowels
by clysters, then to cup the back part of the head or neck, or to use paregoric
applications, such as rose oil, with some vinegar, if in summer ; but, if in win-
ter, especially in persons of a cold temperament, the oil of camomile, with
a fifth-part of vinegar. — See, further, de Med. sec. Locos, lib. ii.
Aetius likewise recommends bleeding, purging, and vomiting, when not
contrarindicated ; and gives very proper directions about the local applica-
tions. He directs to soak a hand^l of wool in some cooling fluid, and, hold*
ing it above the head, to squeeze out the fluid, so that it may fall upon the
bead from a height. Lib. v. 100.
Palladius says, that headach in Fevers is occasioned by repletion and dis*
tention of the veins, owing to fumes arising from the stomach. De Febribui,
c. 13. Nonnus merely abridges our author's account. Epit. c. 147.
Ayicenna's directions about the local applications are brief, but similar to
those of the Greeks. Lib. iv. fen. i. tr. 2. c. 19. Haly Abbas recommends bleed-
ing and attention to the state of the stomach, for the relief of which he in cer-
tain cases permits the use of wine. Pract. iii. 20. Rhases joins preceding au-
thorities in recommending to pour vinegar and rose oil upon the head. They
are to be used cold in summer, but hot if in winter. — Cont. lib.xxx.
We have seen that Celsus approved of cold and astringent applications to
the head. The Methodists condemned this practice, and recommended to
pour hot water upon the open of the head. Hippocrates seems to allude to
tii^is practice, when he says: '* Much hot water poured upon the head re-
nnoves Fever.'^ Aphor. vii. 42. Prosper Alpinus gives an excellent account
of the Methodical treatment. Med. Meth. ii.6.
It appears to be a proper view of the case which Rogerius takes up,
t^9i.iDely, to foment the head with hot decoctions when the headach is critical,
irt order to encourage evacuation by sweating or bleeding at the nose, and,
if otherwise, to use cold applications. Tr. iii. c. 19.
XLV*— ON THE CARE OP STOMACH AFFECTIONS.
Celsus notices these affections. When there is pain and inflammation
about the prtecordia, he recommends to use at first repellent cataplasms, and.
216 COMMKNTARY ON THB SECOND BOOK.
when the inflammation abates, to exchange these for hot fomentations, where-
by the remains of the complaint will be removed. Pain without inflamma-
tion requires no application, as it will be carried off by the Tever itself. Lib.
iii. c. 10.
Galen treats of all sorts of applications for affections of the stomach in his
work, de Med. sec. Locos, lib. viii. Our author follows Aetius, V. 95.
For atony of the stomach, Alexander recommends the applications men-
tioned by our author. When there is aidor of the stomach, a seasonable
draught of cold water, he says, may do much good, whereas if unseasonably
given it will prove highly dangerous. For atony of the stomach, he also recom-
mends hot wine, if not contra-indicated ; and most especially friction of the
extremities. When it can be borne, the bath, he says, proves beneficial in
cases of atony. When there is a sense of cold, he recommends poppies and
wormwood. When the stomach is loaded with offensive humours, he directs
to give an emetic of oil and water. This remedy, he adds, sometimes ope-
rates downwards with the best effects, and he directs to promote its purga-
tive operation by giving suppositories. He concludes, with recommending
to strengthen the stomach by giving a decoction of wormwood with wine, but
forbids to give this medicine until the Fever be abated. Lib. xii. 3.
Of the Arabian authors, Serapioifs account is the fullest, but it is taken
almost word for word from Alexander, tr. vi. 19. iihases states, that he had
often seen bad consequences arise from evacuation having been practised
before attending to the stomach. Contin. lib.xxv.
XLVL — ON INORDINATE CHILLS AND RIGORS IN FETERS.
«
These Febrile symptoms are treated of by Celsus at considerable length.
Lib. iii. 11, 12. Ue properly recommends fomentations of a hot and
dry nature, and friction with calefacient oils. When produced by a bilious
delluxion upon the stomach, he directs to give saltish water so as to operate
as an emetic. He makes mention of the bath, and in certain cases allows
wine. For Galenas sentiments, see de Di/f. Feh'. lib. ii., de Causis Sympt.
ii. 5, de Ineqitali Intemp., de Tremore^ Palp, et Rigor e. The last-mentioned
work, in particular, contains some ingenious speculations on the nature of
rigors. Our author has mentioned Galen's treatment.
Aetius states that tremors take place in Fevers for the most part owing to
errors in eating and drinking. Holding them to be connected with disorder
of the spinal marrow, he directs to apply to the back wool soaked in some
stimulant oil, or to put the patient into a bath of oil. He recommends
castor, both when taken by the mouth and applied externally with the em-
brocations. Lib. V. 130.
According to the explanation of Palladius, rigors and tremors are occa-
sioned by fumes or vapours arising in the internal parts, and being diffused
over the body. C. 24.
The treatment recommended by Haly Abbas is simple and judictous. He
directs to give draughts of hot water, to put the patient's feet into hot water,
and to rub the feet, and, if necessary, the other parts of the body, with cale-
facient oils and the like. Fract. iii. 20.
Avicenna gives a very accurate account of the different modes of treat-
ment, but they are much the same as our author's. He approves of ligatures
to the extremities, of rubbing them witli stimulant oils, or even with lini-
ments prepared with assafcetida and mustard. He says the bath of hot oil
is very beneficial. He also recommends draughts of hot water, and potions
containing opium, which, he remarks, will procure sleep and perspiration.
In certain cases, he allows hot wine, which had been recommended by Hip-
COMMJBNTART ON THB BBCONO BOOK. 217
pocrsites, (Apk. vii. 56.^ lie directs to open the bowels with the hiera, or
piils of assafcetida. Lib. iv fen. i. tr. 2. iihases particularly commends a
draught of hot water. Cont. lib. xxx.
XLVII. — ON 8WBAT8. «
Hippocrates has delivered many interesting remarks on Sweats which oc-
cur in Fevers. See Epidem, — Aphor, — Frognost, pauim.
Galen remarks that profuse Sweats are occasioned by rarity (i.e. relaxa-
tion) of the body, or redundance of the superfluity, or thinness thereof. The
perspiration is checked^ on the other hand, either because the superfluity is
small in quantity, thick, and viscid ; or because the pores of the skin are
constricted. £ither state, he adds, may arise from atony of the natural powers
of the flesh. De Causu Sympt. iii. 9. He says, in another place, that for
tlie removal of copious Sweats astringent and refrigerant remedies are indi*
cated, and that every thing of a relaxing nature ought to be avoided. He
recommends cold wine, and directs to avoid all hot things, also ligatures to
the extremities, emetics, and motion. He approves of cool air medicated by
sprinkling the apartment of the sick with austere things, such as myrtles,
vine shoots, and roses. Therap, ad Glauc. lib. ii.
Celsus directs, when the Febrile Sweats are slight, to rub the body with
oil, and, when more profuse, with roses, quince ointment, or myrtle oil, to
which austere wine is to be added. Lib. iii. 6.
Constantinus Africanus and his prototype Syuesius concur in directing
to check collequative Sweats, by rubbing the body with oil of myrtles, of
roses, &c. They commend an Fpiiheme made of a decoction of roses, the
flowers of the wild pomegranate, galls, and myrtle leaves, to which a proper
proportion of oil is to be added. They also direct to place beside the patient
Vessels filled with water, to sprinkle the apartment with myrtles, roses, &c.
to give him the syrup of roses in cold water, and to avoid exercise.
Serapion recommends styptic and desiccative applications, such as galls>
frankincense, alum, the flowers of vine, myrtles, and tlie like. De Antidotu,
vi. 20.
Haly Abbas briefly recommends friction with styptic oils, and to remove
the patient into a cool apailment. Pract. iii. 24.
Alsaharavius, in like manner, recommends friction with astringent oils,
ssuch as those prepared with roses, pomegranates, and the like. Tr. xxxi. § 2,
Avicenna and Rhases adopt the same plan of treatment as our author. The
tatter directs to rub the body with rose oil, or myrtle oil, to sprinkle the pa-
t.ient with rose water in the decoction of myrtles, to fan him, and to lay in
l^is chamber the tops of cooling herbs and trees. Continens, lib. xxxi.
Prosper Alpinus informs us, that the Methodists approved of cool air, of
Sprinkling the face with cold fluids, of rubbing the body with styptic oils,
^uid of giving astringent wines internally. He also mentions the application
^^f snow over the arteries of the extremities, and pouring cold water over
^hose of the wrist. It is to be regretted, however, that this author too fre-
^:^uently omits to quote his ancient authorities. See Medic. Method, vi. 18.
^nd vii. 3.
Van Swieten gives our author credit for his judicious directions respecting
^:;ool air, ventilation, and removing all superfluous coverings from the body,
^^e questions the propriety, however, of using oily and styptic applications
^o the skin, although be admits that, in certain cases, they might prove ad-
^^i^antageous. Comment. § 717. liogerius cautions not to stop Febrile
*^»weais inconsiderately ; but, when it is judged proper to interfere with
218 COMMBNTART ON THE SECOND BOOK.
them, he recommends to rub into the temples, and over the kidneys, sto-
mach, and spine, a mixture of albumen and rose water. When they occur
early, he directs to have recourse to venesection. The other earlier writers
on Medicine, likewise, treat this complication of Fever in the same manner.
XL VIII. ON COUGHS.
Galen gives some ingenious remarks on the causes of Coughing. He
states that, when any substance becomes fixed in the trachea, as it is a
cartilaginous and hard tube, and incapable of contraction, nature brings on
Coughing, by which a violent expiration of air is induced. A Cough, then,
is nothing but a violent expiration by which nature endeavours to expel any
body that obstructs the air passages ; and, when she cannot accomplish this
at the first effort, she repeats it once and again until she efiect her purpose.
He goes on to state, that such fluids as are very watery, instead of being
brought up, are merely divided or cut asunder by the current of air, while
such as are thick and viscid adhere so closely to the sides of the wind-pipe
that they cannot be removed, and hence violent efforts are necessary to ef"
feet the discharge of them. De Causis Sympt. ii. 4. He treats fully of
compositions for Coughs in his Work, de Comp. Med. sec, Loc. lib. vii. See
the 28th chapter of the Third Book.
Avicenna recommends Cough pills and lohocks made with poppies, the
cold medulla of fruits, starch, and the like. Lib. iv. fen. i. tr. 2.
The prescriptions of Serapion contain liquorice, sweet almonds, traga-
canth, and the like. De Antidotis, vii. 17. Those of Haly Abbas are very
similar. Tract, iii. 22.
A receipt is given by Rhases for Cough pills, the principal ingredients of
which are tra^acanth, sweet almonds, poppy seed. Gum Arabic, and Arme-
nian bole. Divis. i. 52. Many such receipts are given by Myrepsus.
According to Prosper Alpinus, the practice of the Methodists consisted
principally in the administration of demulcents, such as liquorice and al-
mond oil, with the internal application of various oily substances. De
Med, Meth, vi. 7.
XLIX« ON SNEEZING.
Galen explains that sneezing is a still more violent effort of natnre than
coughing, and that its intention is to remove irritating matters from the parts
about the nose, u, a.
Avicenna gives ample directions for the treatment of sneezing ; but they
are evidently copied from our author. Lib. 4. fen. 1. tr. 2. The same may
be said of Haly Abbas. Tract, iii. 22. Rhases recommends warm gruel
internally, to pour warm water on the head, and to apply oil of gouni, of
roses, and the like, to the nostrils. Cont. lib. xxxi.
Cassius Medicus discusses the question why rubbing the nose and eyes
stops sneezing. He supposes that it is by occasioning a discharge from these
parts, whereby the exciting cause is removed. ProbL 45.
L. — ON LOSS OF APPETITE.
Galen's explanation of the Philosophy of the sense of appetite is very in-
teresting. He remarks, that the appetite is a refined species of touch, the
seat of which is the mouth of the stomach, which, therefore, is supplied with
nerves direct from the brain. He goes on to remark, that the earth is to
COMMBNTART ON THB BBCOND BOOK* 219
plants what the stomach is to aDimals, supplying them with abundance of
food as long as it is moistened by seasonable rains ; but, when it becomes
parched by drought, the plants in like manner are dried up for want of du-
triment. (This comparison is borrowed without acknowledgment ffom
Aristotle.) To animals, then, as not being fixed to the earth (with a few ex-
ceptions), nature betowed a stomach which is to them a repository of food,
such as the earth is to plants, and she further gave them a sense of want by
which they have the desire of being filled with food and drink in due season.
This desire of being filled is called the appetite, which arises from a sense
of want, when the veins of the stomach absorb, and, as it were, suck from it»
whereby a painful feeling is excited, the proper cure of which is a supply
of food. The sensation then of sucking constitutes hunger. The loss of ap-
petite then may arise either from the sense of the sucking being lost, or from
the process of sucking (absorption ?) not taking place, or from the body not
being evacuated. De CausU Sympt, i. 7. He treats of stomach aifections
very fully in his work de Med. ttec. Locos, lib. viii.
Treatment similar to our author's is recommended by Alexander, lib. vii.
7, and by Oribasius, Si/nops, vi. 35.
Avicemia evidently takes his plan of treatment from our author, for he re-
commends emeticd, and afterwards fragrant things, with a plaster composed
of firuits laid over the stomach, and wormwood, aloes, &c. internally. Lib. iv.
kn. 1. tr. 2. c. 26. Among the causes of loss of appetite mentioned by him
in another place are, general disorder of the constitution in Fevers, severe
thirst, repletion with depraved humours, and insensibility of the mouth of
the stomach, so that it does not perceive the suction of the veins. Lib. iii.
fen. 1 3. tr. 2. c. 7.
Haly's treatment is nearly the same. He recommends fragrant food, and
fragrant wine after the acm^ of the fever, gentle laxatives, and such mode»
of exercise as he can bear. Fract. iii. 21.
LI. ON BULIMOS, OR INORDINATE APPBTITB.
AccoRoiKG to Galen, Bulimos is occasioned by a want connected with
^tony, and coldness of the stomach. De Camis Sympt, i. 7. Alexander on
^he other hand says, that it arises from inordinate heat and weakness of the
stomach. He informs us that the vulgar practice consisted in giving fra-
grant things, binding the extremities, rousing by pinching, giving bread
Soaked in wine, and, in short, administering every thing calculated to cool
«tiid strengthen the body. Others, he says, give opium with cold water, in
Order to extinguish the heat of the stomach. However, he disapproves oi
^11 these things, and directs to give food of difficult digestion. He relates
tHe case of a woman affected with Bulimia who was cured by having a pur-
gative powder given to her, which occasioned the discharge of a worm nK>re
t.ban twelve cubits long. Lib. vii. 6.
Aetius and Oribasius adopt the Theory of Galen, and recommend nearly
tlie same treatment as our author. Aetius also directs to apply over the.
stomach cooling cataplasms made of dates, quinces, or polenta, boiled in
<liluted wine.
Serapion remarks, that Bulimos is distinguished from the Canine Appe>>
t.ite, by the desire in the former complaint being for proper articles of food,
^vvhereas, in the latter, it is for depraved or improper food. His treatment
in most respects is like our author s. He also recommends a mixture of old
odoriferous wine, camphor, and lignum aloes. Tr. ii. c. 11.
Avicenna and Haly Abbas agree with Galen in stating that Bulimos is
<^«nnected with a cold interoperament of the stomach, whereby the sensibi-
220 GOMMBNTART ON THB SECOND BOOK.
lity and attractive power of the stomach are diminished. Their (reatroent in
principle is quite similar to our author's. In extreme cases they agree with
Galen in recommending the Theriac. One of Rhases' authorities recom-
mends cardamom, cubebs, and the like. Cont. lib. xi.
The Classical reader is referred to Callimachus for a grand poetical de-
scription of Bulimia. Hi/mnus in Cererem.
LIL— ON THB CANINB APPBTITB.
According to Galen, one of the causes of the Canine appetite is an acid
cacochymy, and another is an immoderate evacuation of the whole body, oc-
casioned either by strong heat or weakness of the retentive faculty, u. a.
Hippocrates recommends the liberal use of wine, in one of his Aphorisms,
lib. ii. 21 ; and Galen, in his Commentary on the same, states that the wine
should be tawny-coloured or red, and devoid of astringency. In another
place, he directs to purge away the offending humour witli the Hiera of
Aloes. De Med. sec. Locos, lib. viii.
Our author borrows part from Oribasius. S^nops. vi. 34.
Alsaharavius recommends the same plan of treatment as the Greeks, when'
the disease is connected with a cold intemperament ; but when with a hot,
he directs to have recourse to bleeding, cold fruits, and cooling applications
to the stomach. Pratt, xvi. c. 1 1.
Rhases and Avicenna approve in general of our author's plan of treat-
ment, to which, however, they suggest some improvements ; wnen the cause
of the complaint is an acid phlegm, they direct to give fatty things with mus-
tard, pepper, garlic, and the like. When connected with black bile, they
approve of bleeding. When it arises from worms, they, of course, approve
of Anthelminthics. Sarac, one of Rhases' authorities, recomm,ends emetics
and purgatives, with a cupping-instrument applied over the stomach. Ccm-
tinenSy lib. xi.
Serapion's treatment is entirely like our author's. Tr. ii. c. 10.
Prosper Alpinus, the modern advocate for the doctrines of the Methodists,
approves of our author's practice. Med, Meth, xi. 7.
LIII. ON THIRST.
The greater part of this chapter is taken from Galen (de Cans. Symp.
u. s,), who, as usual, handles the subject very philosophically. Oribasius
treats of it in nearly the same terms as our author. Spnops. vi.'37, 38, 39.
Aetius remarks that there are two causes of thirst, a want of humidity, or a
redundance of heat. In Fevers, then, both these causes co-operate to occa-
sion thirst ; for, there is excess of heat originally, and dryness comes on ow-
ing to the fluids of the body being consumed by the Febrile heat. Lib.
v. 119.
The question was keenly agitated in the ancient schools of medicine, whe-
ther cold drink might be safely given in Fevers. Hippocrates was a great
advocate for this practice, giving his patients barley-water and acidulated
draughts very freely at all periods. Asclepiades, on the other hand, as Cel-
sus and Alexander informs us, forbade even to wash the patient's mouth with
water during the first stage of a Fever. Celsus is disposed to hold a middle
course between these opposite methods of practice. He particularly ap-
proves of washing the mouth and fauces frequently with cold water, because,
as Erasistratus had properly remarked, these parts oflen require cold li-
quids, while the internal parts are not in want of them. Philumenus (ap.
OOMMBNTART ON THE SECOND BOOK. 321
Aetium) also strongly recommends gargles, but forbids to give cold drink
freely until after the acm^ of the Fever. Alexander informs us that the ce-
lebrated Archigenes allowed his patients the free use of cold water and aci-
dulated drinks. He himself does not speak very decidedly for or against
this practice. He approves, however, otcold applications externally; and>
accordingly, directs to apply to the region of tne stomach a bladder filled
with cold water, ice, or some cooling decoction.
Of the Arabians, Serapion expresses himself most decidedly in favour of
cold drink. Avicenna forbids to give much at a time. See also Haly Abbas,
Pract. iii. 22. Alsaharavius, Fract. xvi. 14. Averrhoes, CoUiget. vii. 24,
and Rhases, Contin. lib. xxx.
The pill mentioned in the end of the chapter is from Dioscorides.
It appears singular that all the ancient authorities should agree in stating
that liquorice quenches thirst, while the modems hold that it rather increases
it — (See Edinhurgh Dispensatori/.) And yet I can affirm that the common
people in Scotland are of the same opinion as the ancients. — De gustibtif
non est disputandum I
Prosper Alpinus seems to agree with the ancients as to this property ef
liquorice. He represents the Methodists as having disapproved of the free
use of cold water in Fever. Med. Meth. vi. 7.
Fabius Paulinus gives an admirable exposition of the philosophical doc-
trines of the ancients on this subject. He remarks that there are three dis-
tinct species of thirst. The 1st is occasioned by the fauces and sesophagas
being arier or hotter than natural. This state, if it supervene upon sleep,
is to be cured by watchfulness, or versa vice. In the 2d, the veins over the
whole body are filled with hot and acrid humours. In the 3d, the mouth
of the stomach, lungs, or heart, are pretematurally hot or dry. Marc, Pra»
kct. p. 315.
LIV. ON ROUGHNESS OP THE TONGUE.
This chapter is mostly taken from Oribasius. Synop. vi. 43.
Aetius recommends nearly the same treatment. He also states that, when
t'ie roughness of the tongue is difficult to remove, it may sometimes be ac-
^^mplished by rubbing it with the fat of fowls, or with fresh butter. Lib.
^- 118.
Ocelius Aurelianus directs to clean the tongue with a sponge squeezed out
^^ liot water. Avicenna recommends for this purpose an instrument called
^^<Mizarany and also directs to use sugar, or a sponge with a small quantity of
!^l( and rose oil. He likewise makes mention of the salt brought from
^^clia, possessing the colour of salt and the taste of honey. (Lib. iv. fen. 1.
?*"* 2. c. 22.) The Pseudo-Dioscorides recommends mint triturated with
^'^^Hey, red sumach, and rose oil with honey, or by itself. Eupornt. ii. 18.
X^rosper Alpinus was of opinion that the Indian salt mentioned by our
^^t.lior and Avicenna was the same as our sugar. Sprengel, however, main-
^ii:is, that the Greeks and Romans were utterly unacquainted with our
^^gar. Kei. Herh. Hist, and Notie in Dioscoridem. Lib. ii. 104. The
^'^el arundinum appears, in fact, to have been a natural concretion, and it
^^s most probably the same as the Indian salt. See Dr. Milword's Letter
^o Si|. Hans Shane. The Cane from which the ancient Sugar was procured,
^ now called by botanists the Bambusa Arundinaceoy or Bamboo Cane.
222 COMMBNTABT ON THB SECOND BOOK.
LV. — ON NAUBBA.
Obibasius recommends the same treatmeDt. S^nop, vi. 40. Our author
appears to have condensed the lengthy account given by Galen and Aetius.
Lib. ix. c. 5.
Alexandei: also treats of the subject at gpreat length, but I can only af-
ford room for a few extracts. When the nausea arises from plethora, he
directs to bleed ; and, when the plethora is connectei with vitiated humours,
he recommends both to bleed and purge. When Bilious* or Melancholic
humours occasion the nausea, he recommends dilution at first by giving te-
pid water or the like, and then directs to evacuate them by purging or
emetics. When the humour is an acrid or sweet phlegm, he recommends
oxymel, radishes, and the like. When a serous and thin humour is impact^
ed in the stomach, he directs to evacuate it by procuring vomiting witn te-
pid water or ptisan. Lib. vii. c. 13.
Serapion appeal's to have copied from our author. Lib. iii. c. 5. See Avi-
cenna, lib. iii. fen. xiii. tr. 5. c. 8. Rhases recommends to apply over the
stomach a cold plaster with snow. When the nausea is oppressive, he di-
rects to promote vomiting with tepid water. Cont, lib. xi.
Prosper Alpinus says that the Methodists approved of giving a weak aro-
matic wine in such cases, and that, when the stomach was very much loaded,
they administered emetics. Med. Meth, vi. 8. Sydenham was fond of giv-
ing emetics in cases of Fever attended with nausea. Van Swieten, however,
often found that, when administered early, they failed to afford relief: he,
therefore, preferred giving oxymel and the like, which, in the course of a
few days, usually had the effect of producing vomiting with great relief.
Upon the whole, the treatment recommended by Boerhaave and Van Swie-
ten is little different from our author's. They very properly forbid to use
emetics, when there is any reason to suspect inflammation of the Liver or
Stomach. See Comment, § 644. In the plague. Dr. Russel treated nausea
by giving draughts of tepid water, or small doses of Ipecacuanha.
LVI. — ON YOMITINO OF BILB.
This is taken from Oribasius, Si/nops. vi. 41.
Alexander states that the proper remedies for vomiting occasioned by a
redundance of bile, are diluents and refrigerants. He recommends internally
{>tisan, lettuces with a small quantity of vinegar, &c. For drink, he particu-
arly approves of cold water, but forbids to give much at a time. When the
strength fails, he permits to add a small proportion of hydromel, wine, or the
like, to the water. In certain cases, when the patient is troubled with in-
somnolency, he directs to add the heads of poppies to his drink. He also
recommends external applications possessed of tonic, cooling, and impellent
properties. Lib. vii. c. 17.
Serapion recommends not to interfere with a Critical vomiting. When it
is continued, he directs to give clysters and gentle purgatives at first, and
afterwards vegetable acids and astringents. When these remedies fail, he
directs, if the strength be good, to bleed from the arm. He also makes men-
tion of external applications, possessed of astringent and refrigerant proper-
ties. Tr. iii. 15. Haly Abbas, in like manner, cautions against stopping a
Critical vomiting. Pract, iii. 24. Alsaharavius directs to give draughts of
tepid water at first, and afterwards the infusion of wormwood or of aloes.
He also recommends external applications of a strengthening nature. Pract,
xvi. 20. Avicenna's plan of treatment appears to have been copied from our
V
COMMBNTART ON THB SECOND BOOK. 228
author's. Lib. iv. fen. i. tr. 2. Rhases recommends acid drinks, such as the
decoction of pomeg^ranates and the like. Coni, lib. xi.
According to Prosper Alpinus, the treatment of the Methodists consisted
in administering sub-acid fruits, the juice of wormwood or of mint in wine,
and in applying externally tonic Epithemes, containing sumach, galls, mas-
ticb, and the like. Med, Meth, xii. 1 1 .
Vomiting in Fevers b no doubt generally connected with a state of the
stomach and neighbouring parts approaching to inflammation. See an ex-
cellent account of the Vomitus Febrilis, by Van Swieten, Comment. § 652.
Vomiting is mentioned by all the writers on the Plague as a common and
un&vourable symptom of that disease. See Thucydides, and Russel on the
Plague, p. 92.
LVIL— ON HICCOUGH.
This chapter is copied from Oribasius, Si/nops, vi. 42.
According to Galen's explanation, Hiccough is occasioned by any exciting
cause which rouses the stomach to violent motions. He states that sneezing
proves a cure to it. De Cans. Sym, iii. 6. Celsus says, in like manner, << Sin-
gultus stemutamento finitur.'' He states that frequent and unusual bickuping
is symptomatic of an inflamed liver. Lib. ii. 7. Aetius, in like manner says,
that singultus in Fevers often arises from inflammation of the stomach and
neighbouring parts. He treats of the complaint at great length. When it
arises from pungent humours, he directs to give first emetics, and afterwards
narcotics, such as opium, &c. He also recommends to apply a cupping-
instrument with great heat to the breast, stomach, and back, in certain cases.
Lib. ix. 5.
Alexander gives an interesting account of this affection, for which he re-
commends various remedies. When connected with inflammation of the
stomach or liver, he directs to begin with bleeding. When it is occasioned
by thick and viscid humours, he recommends an oxymel of squills, the com-
position of which he minutely describes. Lib. vii. 15.
When singultus is connected with a,cold cause, the author of the Euporis-
ton ascribed to Dioscorides, recommends to put the feet into hot water, to
take tepid draughts, and apply hot fomentations to the stomach. Lib. ii 4.
Though there is perhaps nothing original in the views of the Arabians,
they treat of hiccough very fully and accurately. Among the causes of it
mentioned by Aisaharavius is inflammation of the stomach and liver, in
which case he recommends venesection. When connected with excessive
heat of these parts, he approves of cold air, cold drink, and refrigerant
draughts, containing prunes, tamarinds, camphor, Src. Tr. xvi. 18. The
causes of hiccough, according to Sempion, are, evacuation, repletion, pun-
gent and cold humours. His remedies are emetics, calefacients, and attenu-
^ts, which are to be directed according to the nature of the exciting cause.
Tr. iii. 17. See also Avicenna, lib. iii. fen. 13. tr. v. c. 25., Rhases,
Bwis. 62., ad Mansor. ix. 65., ContinenSf lib. xi. Rhases recommends ca-
le&cients, such as cumin, pepper, rue, and the like, in vinegar. He also
approves of emetics and laxatives.
Prosper Alpinus says that the ancient Methodists approved of Oily Eme-
tics. Meth. Med. vi. 8. It will be remarked, that our author states that
^ny persons are seized with hiccough if they take peppers with wiue.
^sper Alpinus mentions that they had this effect on him (de Pras. v. et
n. M^r. iii. 9.); and 1 have further to state the same of myself.
Hogerius, probably copying from Rhases (for the practice of the earlier
DQodem physicians is mostly borro\<red from the Arabians), recommends prin-
224 COMMBNTART ON THX SECOND BOOK.
ci pally cale^Eicient, attenuant, and carminative medicines, mixed witli gentle
laxatives, such as prunes. Tr. iii. c. 21. For Hiccough in Intermittents,
Cleghom recommends to apply a cuppins-instrument to the pit of the sto-
mach, and give laudanum with tincture of castor internally.
LVIII. ON CONSTIPATION AND DIARRHOSA.
Galek forbids venesection when the Fever is complicated with Diarrhoea.
Therap, ud Glauc, lib. i.
When the belly is constipated, Celsus recommends laxatives, diuretics,
and sudorifics. lie adds, it may also be proper to let blood, practise gestation,
enjoin abstinence from food and drink, and keep the patient from sleeping.
He likewise recommends the bath, both of tepid water and of oil. When the
bowels are loose, he enjoins rest and sleep, directs to restrain sweating, and
forbids all exercise except gentle gestation. He also directs to excite vomit-
ing by copious draughts of tepid water, unless the complaint be of long
standing, or there be pain of the throat, prscordia, or side. Lib. iii. 6.
Alexander forbids to use Narcotics, unless in cases of extreme urgency.
Avicenna joins him in laying down this injunction, and otherwise directs to
treat the Diarrhoea Febrilis upon general principles. Lib. iii. fen. 16. tr. 1.
c. 4. Haly Abbas directs to treat Fever, when complicated with constipa-
tioD, by giving gentle laxatives, such as prunes aud tamarinds, or, if these
prove injurious to the stomach, by administering clysters. When the Diar-
rhoea is complicated with a discharge of blood, he recommends to add to the
other medicines Armenian earth, purslain, sumach, or such like astringents.
Pract. iii. 24. See Serapion, tr. iii. 17., Hhases, Divis, 67.
According to Prosper Alpinus, the ancient Methodists approved of astrin-
gent applications and astringent clysters for Febrile Diarrhoea. Med, Meth.
▼i. 10. Sydenham and Van Swieten agree with Alexander and Avicenna in
forbidding to stop Diarrhoea in Fevers by means of opiates, unless in ex-
treme cases.
liogerius discusses fully the question of the propriety or impropriety of
bleeding in cases of Fever complicated with Diarrhoea. Upon the whole, he
rather disapproves of it, unless the system be strong and the symptoms vio-
lent. He approves of assisting nature in the way she points at.
LIX. — ON TRICKLING OF BLOOD AND HBMORRHAGB FROM TBB
NOSE.
Hippocrates declares that profuse bleeding at the nose indicates a dis-
position to convulsions which venesection is calculated to remove. Pradict,
i. 21. Galen, in his Commentary, remarks that the convulsions are broi^t
on by the unseasonable use of cold applications to stop the hemorrhage. He
strongly recommends to bleed from the arm of the side from which the blood
flows. In another place, he states that Epistaxis in Acute Fevers is an un-
favourable symptom. In. iii. Epidem. Comment.
Aetius mentions that Hippocrates had declared a bleeding from the nose
on the fourth day of a fever to be a very bad symptom. He recommends to
encourage the bleeding by irritating the nostrils with a stalk of grass. Oar
author, it will be observed, directs to perform this operation with the T^m,
a species of grain several times mentioned by Theophrastus, in his History
of Plants, by Galen (Je Aliment, i. 13.), and by Alexander Trallian (lib.
vii. 5.) Sprengel makes it to be a species of Secale or Rye ; but Stack-
COMMBMTABT ON THB 8B0ONO BOOK. 225
house, the English editor of Theopfarastus, is of opinion that it was the
TVt^tctMi SpeltOy or Spelt. *
When it is judged proper to restrain the hemorrhage, Avicenna recom-
mends ligatures to the extremities, and cold and styptic applications to the
nose and adjoining purts. Lib. iv. fen. i. tr. 2. c. 14. and lib. iii. fen. v. tr. 1.
Serapion agrees witn most of the ancient authorities in commending a mix-
ture of frankincense and aloes, when applied on the down of a hare. He
also directs to apply a sponge soaked in cold water to the temples and fore-
head. Tr. ii. 13. When bleeding at the nose occurs in a fever, Rhases for-
bids to stop ity unless it prove excessive; in which case, he directs to apply
a cupping-instrument, without scarification, to the hypochondrium ; to tie
ligatures about the testicles; to pour cold water on the head ; and to driidL
cold water. Divis. 40.
Boccacio mentions Epistaxis as a fatal symptom of the Plague of 1 348. —
Decameronf IrUrod, Dr. Russel found it an un&vourable symptom of the
plague of Aleppo.
According to Prosper Alpinus, the ancient Methodists forbade to stop a
Critical Epistaxis, unless it proved excessive, when they approved of cooling
tieatment, as recommended oy our author. Med, Meth. vi. 10.
Rbgerios remarks that it is an important point to determine whether the
Epistaxis be a Critical evacuation or otherwise, as, in the former case, it
ought not to be meddled with. When it appears not to be Critical, be di-
rects to produce revulsion, by bleeding at the arm, and to apply astringents
to the forehead and sides. Tr. iii. c. 19. The other earlier writers adopt
the ancient views in like manner.
LX« ON DBLIQUIUM ANIMI.
l^EABLT the same account of Deliquium Animi in Fevers is given by
AetiuSy^Lib. v. 101, et teg.) and by Oribasius, {<ie Morb, Curat, iii. 7.) But
-^11 these authors are, in fact, indebted to Galen. Therap, ad Glanc, lib. i.
Aetius thus states the distinction between Syncope and Deliquium : — << De-
liquium makes its attack suddenly, depriving the person of sense and mo-
"tion, but is not necessarily accompanied with sweats ; but Syncope seizes
"^pon persons, both when asleep and when awake, and is necessarily attended
"With sweats, called Syncoptic.''
Alexander delivers a ftiU account of the subject; but his principles of
"^eatment scarcely differ in any respect from those of Galen. Lib. xii. 13.
Haly Abbas directs, when the Deliquium proceeds from a defluxion of
^Himours upon the stomach, to apply ligatures to the extremities, to dash water
^^>n the face, to fan it, and to give vinegar and pepper. He recommends to pre-
sent sleep, which has a tendency to extinguish the powers of the primary
'^cera, by occasioning a determination inwardly. When it proceeds from
'dryness, he directs to give wine, the decoction of quinces, of apples, and the
^ike. If it happen at Uie commencement, he recommends to give a piece of
^>read soaked m wine. Tract, iii. 25.
The Arabians in general do not acknowledge the distinction between Syn-
<5ope and Deliquium.— See Averhoes, Colliget. vii. 16., Serapion, vi. 19.,
Phases, od JUofisor. X. 13.
Avicenna seems to point at the distinction, but it is not perceived by his
^nnslator."'' Rhases recommends the same treatment as Haly Abbas. He
i^ommends hot wine, food of easy digestion, sprinkling of the face with cold
^ater, and the application of ligatures to the extremities. Continens, lib.
nxi.
226 OOMMBNTABT ON THB SBCOND BOOK.
Fainting and Syncope are most commonly met with in Pestilential Yeren.
See Russel on the Plague, p. 89.
LXI. ON ULCBBATION OVBR THE 08 SACRUM.
This chapter is taken from Oribasius, Synops, vi. 44.
Aetius remarks that, in prolonged Fevers, the fleshy parts of the body be-
ing wasted, ulceration takes place in those parts upon which the patient lies.
These sores, he adds, spread deep, and have hard thick edges. When the
back becomes red and painful, he directs to surround the adjoining parts
with a circle of wool, so as to relieve the affected part from the effects of
pressure ; and then a cerate of rose or myrtle oil, containing litharge, ceruse,
and burnt barley, is to be applied. He particularly commends a composi-
tion consisting of litharge, oil, wax, and honey, mixed with rose-oil. He also '
makes mention of the applications recommended by our author. He con-
cludes with directing to use milder applications when the ulceration has
stopt spreading. Lib. v. 127.
Alsaharavius directs to treat the redness of the back occasioned by lying
long in bed, with the flower of millet, barley, or lentils. When pustules
form and break, he recommends to apply an ointment containing ceruse.
Pract. xxix. §. 1. c. 26.
APPENDIX
TO THK
COMMENTARY ON BOOK SECOND.
ON 8MAHiL-P0X AND MEASLES.
The reader, I am sure, would be disappointed, if I were to quit the subject
of Fever, without making any allusion to the history of Small-Pox and
Jdeasles. I will, therefore, conformably with my general plan, give a brief
:aK>tice of the descriptions of these diseases which we meet with in the works
<^>f the ancient physicians. In the first place, then, I may mention that, after
Kaving read every word of eveiy ancient writer on medicine that has come
"^own to us, I can confidently a&rm that the Greeks and Romans are alto-
^gether silent on the subject, and that we are indebted to the Arabians for the
^^arliest accounts which we have of these diseases*. Rhases, indeed, pretends
^^provided the Introduction to his Treatise on Small-Pox be not spurious) that
^Cklen had delivered some imperfect descriptions of Small-Pox ; but he
ould appear to have been led into this mistake, by following some iuac-
urate translation of the Works of Galen into the Syriac language ; for no
which would justify the interpretation which Rhases puts upon
em are now to be found in the origmal. lately, Dr. Bateman attempted
< show, that allusions to Measles and Small-Pox are to be met with in the
orks of several of the Greek authors; but I entirely agree with Drs. Mead
d Freind, who maintain the contrary. In an Arabian MS. preserved in
e University of Leyden, it is stated that the Small Pox and Measles first
ppeared in Arabia, about the year 572, p. c. — See Reiske, Opuscula Medicuj
.10.
Although Rhases be the most ancient writer whose account of Small-Pox
^-Dd Measles has come down to us, he does not pretend to have been the first
^^f his countrymen who had noticed them, but gives extracts from the Works
^^f the Elder Mesne, the Elder Serapion and Aaron, wherein mention is made
^^ithem. According to Rhases, the common cause of Small- Pox is a fer-
^^entation in the blood ; and hence the disease is most apt to seize children,
^^^hose blood is hotter than that of other persons. He was well aware, how-
^'^^r, that the disease is capable of being propagated by contagion, for he
^^nks the Pestilential Fever or Small-Pox among the diseases '* qui transeunt
^^uno ad alios.*' The symptoms, as described by him, are, continued fever,
V^in in the back, itching at the nose, disturbed sleep, and afterwards redness
q2
228 AFPBNDIX TO THE COMMENTARY ON BOOK SECOND.
and fulness of the face, pain of the throat, difficulty of breathing, diyness of
the mouth, thick spittle, hoarseness, headach, inquietude ; and these symp-
toms are followed by the characteristic eruption of the Small-Pox or
Measles ; but in the case of the latter there is more anxiety of mind, sick
qualms, and heaviness of heart ; and in that of the former there is more pain
in the back, heat, and inflammation of the whole body, especially in the
throat, with a shining redness. He then lays down the rules of treatment.
He directs to bleed from the arm at the commencement, provided the patient
be more than fourteen years old, but by a cupping-instrument if he be younger.
He forbids, however, to abstract blood after the eruption is come out. He
allows to take light kinds of animal food, with acids ; and for drink he re-
commends water cooled with snow, or cold spring water, or some diluent
and acid draught, such as' barley-water acidulated with pomegranate juice.
Aaron, one of his authorities, forbids, however, to give cold water when the
eruption is coming out. He directs to sprinkle the chamber with cold water,
and even at a certain stage permits the patient to go into the cold bath. He
recommends abstinence from new milk, wine, dates, honey, mutton, beef,
shell-Bsh, and all high-seasoned and heating things. The rest of his general
treatment 1 need not give in detail. Suffice it to say, that the medicines re-
commended by him are, for the most part, vegetable acids and astringents.
Upon the whole, the earlier part of his treatment consists of bleeding, cold
drinks, and acid draughts. For hastening the eruption, he directs to wrap
up the patient closely in clothes ; to rub his body all over; to keep him in a
room not very cold; to give him some cold water to drink; to put on a
double shirt ; and to place near him two small basins of very hot water, one
Defore, and the other behind him, so that the vapour may be diffused all
over his body, except the face ; but he prudently directs not to allow the
moisture to cool upon the body, but to get it carefully wiped off. All fujp-
naces and hot baths he condemns, as overheating and weakening. He very
much commends figs for promoting the eruption. He afterwards gives very
minute directions about the treatment of particular parts, such as the eyes,'
the throat, and the nose. For the eyes, ne recommends various astringent
lotions or colly ria, such as galls and rose-water, sumach, pomegranate rind,
&c. The care of the throat he justly holds to be a very important considerar
tion, and recommends to bleed when there is acute , pain, and to gargle
with cold water, or with astringent decoctions, such as those of acid pome-
granates, sumach, and the juice of mulberries. When the pustules on the
limbs are large, he directs to open them ; and, when there is great pain in the
soles, he recommends to rub them with warm oil, or to put the feet into hot
water. When the pustules seem to stand in need of ripening, he directs
foment the body with the steam arising from a hot decoction of camomile^
violets, and the lik&; and, when too humid, the patient is to be laid
pounded roses, rice meal, or millet seed. For removing the scabs
eschars, he recommends to rub them with the warm oil of sesame, or oil
pistaches; but the larger are to be cut off carefully without any application:^
of oil. For removing the specks on the eye, he recommends many stimulac^c
collyria, containing antimony, verdigris, sal ammoniac, tutty, camphor.
For removing cicatrices or marks on oUier parts of the body, be mentioi
various applications, containing litharge, bastard spurge, &c.* When
belly is loose, either in Small-Pox or Measles, which, as he remarks,
commonly the case on the decline of the Fever, he recommends to abst
from all laxative things, and to give barley gruel, to which the meal of
megranate seeds may be added ; or, if the looseness increase, gum aral
&c. may be added to the drink. He adds, that it sometimes happens
the bowels require to be opened, and he directs to effect this by mean;
niyrobalans, prunes, and the like. When in Measles there is much appear-
AFPBNDIX TO THE COMMENTARY ON BOOK tXCOND. 229
ance of vitiated bile, he directs to procure the discharge of it He points
out the difference between Distinct and Confluent Small-Pox ; and remarks,
that the latter isiar more dangerous than the other. He also correctly states,
that when, in Measles or Small-Pox, the eruption is suddenly determined in-
wardly, it is a fatal symptom. He all along inculcates, that Measles and
Small-Pox are nearly allied to each other; and I may mention, by the way,
that the learned Dr. Mead is of the same way of thinking. He !»ays, " The
Measles have a great affinity with the Small-Pox, being originally bred in
the same country, and propagated in the same manner by infection into
distant parts of the world, and never seizing any person but once." The
simultaneous occurrence of Small-Pox and Measles in certain cases, will be
admitted as a presumptive proof of a certain alliance between the two
diseases. — (See Mr. Delagarde*s Paper in the Medico-Chirnrgical Transact
t'umsy vol. xiii. p. 1.) I may mention further, that Sidobre, Sennertus, and
most of the authorities of that period, maintained this opinion. Even Syden-
ham holds them to be of the same nature.
Georgius, one of the authorities quoted in his Continent^ says that Measles
arise from blood mixed with much bile, and Small-Pox from gross blood
mixed with much humidity. He states that the danger is proportionate to
the pain in the throat and difficulty of brefathing. The Elder Serapion, as
quoted by him in the same work, directs, if it is the winter season, to bum
the wood of Tamarisk, &c. beside the patient.
In his work Ad Mansorem, he recommends nearly the same treatment as
that which we have been detailing from his Tractatus on Small-Pox ; but
does not speak so decidedly in favour of cold drink.
Avicenna's description of Small-Pox and Measles is very similar to that
of Rhases. He conhdently pronounces them to be contagious diseases; He
states correctly, tliat, when Small-Pox proves fatal, it is usually from the af*
^^tion of the throat, or from the bowels becoming ulcerated. Sometimes, he
^dds, the disease superinduces bloody urine. He agrees with Rhases that
Measles is a bilious affection, and that it differs from Small-Pox only in this,
Uiat in the former the morbific matter is in smaller quantity, and does not
pass the cuticle. His treatment also is little different. At any period dur-
ing the first four days he approves of venesection, but forbids it afterwards.
^e recommends cooling and diluent draughts prepared from tamarinds, and
the like. He directs to give figs to facilitate the eruption of the pustules, and
^rbids to give cold drink after they begin to come out. When the pustules
^*e large and fully formed, he approves of letting out their contents with a
Sold needle. His treatment of the throat, eyes, belly, and hands, is nearly
the same as that recommended by Rhases. When ulcers are formed after
t^e falling off of the eschars, he directs to dress them with the White Oint-
Hcieuty composed of Ceruse and Litharge. — See Lib. iii. fen. 1. tr. 4.
Serapion*s account of Small-Pox and Measles, as is remarked by Haly
A.bbas, is very defective. He treats of them along with apostemes, and his
description of the symptoms is far from being accurate.
Avenzoar, in his Treatise on Epidemical diseases, treats incidentally of
l^easles and Small-Pox, for the cure of which he recommends principally
gentle purgatives, such as tamarinds, with cooling and acid drinks. Lib. iii,
Ir. 3. c. 4.
Alsaharavius also mentions them briefly among the Pestilential diseases;
"but his deserrption of them is not to be compared with that of lihases.
According to Haly Abbas, Variola is produced either by external causes,
such as a Pestilential state of the atmosphere, or from respiring the air of a
place which has been tainted with the effluvia from the pustules of persons
uffected with the disease; or it may arise from an ebullition of the blood
vrhenitis loaded with gross humours which nature endeavours to cast out-
230 AFPXNDIX TO THB COMMBNTART ON BOOK BBCOMD.
wards. He then briefly describes several f arieties of the disease, differing
from one another in degrees of malignity; and among them he ranks
Rubeola, which is occasioned, he says, by a hot thin blood, and is not of a
bad nature. In it, he says, the eruption, when at its height, resembles mil-
let seeds, or is somewhat larger, the colour is red, and the pustules discharge
nothing. The precursory symptoms of Small-Pox are, Fever, swelling of the
face, itching ot the nose, inflammation and redness in the face and other
members, heaviness of the head, and roughness of the throat. TAeor. viii.
14. With regard to the treatment of Variola and Rubeola, he recommends
venesection during any of the first three days; or, if the patient be a child,
he directs to apply a cupping-in.strument to the back. The patient is then
to be made to drink barley-water, in which jujubes and sebesten plums have
been boiled ; syrup of poppies is to be added, if the cough be troublesome, or
the pain of the throat severe; and spoon-meats prepared with spinage, orach,
and the like, are to be given. When the eruption does not come properly out,
he recommends a decoction of fennel, lentils, figs, &c. to be taken cold. (By
the way, this practice is favourably mentioned by Fracostorius, a writer of
the t6th century, de Marb, Cont,) When there is asperity in the chest, he
directs to give the mucilage of fleawort, linseed, and the like, and forbids
all heating things. The patient is to be kept npon a low diet,** as in other
Fevers; and his apartment is to be fumigatea with aromatics, such as sandal-
wood, myrtles, and roses. When tlie belly is constipated, he directs to give
barley-water with manna, prunes, and the like; or, if loose, barley-water
with myrtle seeds, gum Arabic, Armenian, or Ci*etan earth (chalk ?). He
forbids to give purgatives after the 7th day, especially in Rubeola, as there is
danger of diarrhcea or dysentery being superinduced ; and, if tliese affections
should come on, he directs to stop them with astringents. He recommends
to pay particular attention to the eyes at the commencement, and with this
intention directs to bathe them with an astringent decoction. No animal
food is to be allowed, until the eruption and heat are gone.
HEADS OF THE THIRD BOOK.
This Book, which is the Third of the whole Work, treats of Topical
complaints, beginning with the Head and ending with the Toes.
1. On Alopecia, Ophiasis, and Baldness.
2. Compositions for Dyeing and Curling the Hair.
3. On the Affections of the Skin of the Head.
4. On Headach.
5. On Cephelsea and Hemicrania.
6. On Phrensy.
7. On Phlegmon of the Brain.
8' On Erysipelas of the Brain.
9. On Leftliargy.
10. On Catochus, or Coma Vigil.
11 • On Loss of Memory and of Reason^ Carus, and Fatuity.
12. Oq Vertigo.
13. On Epilepsy.
1^' On Melancholy, Mania, and Dssmoniacs.
15. On Incubijs, or Night-mare.
^^' On Lycaon, or Lycanthropia.
^^* On Lovers.
^^' On Apoplexy, Hemiplegia, or Paralysis.
^^' Oq Spasm.
^^. On Tetanus, and its different yaneties.
2^- OuTiemblkigs.
22. On Complaints of the Eye.
^^' Matters relating to the Ear.
^^- On Affections of the Nose, and of the Sense of Smell.
^^' On Affections of the Face.
^^" On Affections of the Mouth.
*^' On Quinsy, and Affections of the neighbouring parts, also on those who
are Strangled or otherwise Suffocated.
*^' On Coryza, Catarrh, Affections of the Trachea, and Cough.
^- On Orthopnoea, Asthma, and Dyspncea.
232
30. Od PiieumoDJa.
31 . On Spitting of Blood.
33. On Empyema and Phthisis.
33. On Fleurisjt.
34. On the Affections of the Heait.
35. On AffeclloDs of (he Mamnw.
36. On Offensive Smells and Exudations of Ihe Ann-pits.
3T. On Affections of the Stomach, Urpochondria, and Belly.
38. On Ineation of the Stomacli.
39. On Cholera and Diarrhcpa'.
40. On Lienteria and Caliac ASections.
41 . On Tenesmas.
43. On Dysenter)'.
43. On Colic.
44. On Ileua.
45. On AfTectiona of the Kidneys and Bladder.
46. On Affections of the Lirer.
47. On Cachexia.
48. On Dropsies.
49. Od the Spleen.
50. On Jaundice.
51. On Prolapsus of the Navel.
52. HowtoinaketbeHairof theChinandPobeslateofGrowth; alsoon
the Preserration of the Privy Parts and Testicles; and likewise of
Depilatories.
53. On Bnboitocele, Gnlerocele, and Hydrocele.
54. On InSammatioQ of the Testicles and Scrotum, and other Complaints
of those parts.
55. On Gonorrhcea, and Polluted Dreanu.
56. On Satyriasis.
57. On Priapism.
58. On Impotence.
59. On Affections of the Pudenda and Anus.
60. On Affections of the Uterus,— and, firet, of Uie Menstrual Discharge.
61. On lUtention of the Menses.
62. On Immoderate Menatruitiou, and Hemorrhage of the Uterus.
63. On the Female Discharge.
64. On Inflammation of the Uterus, and Displacement of the same.
65. On Abscess of the Uterus,
66. On Ulceration of the Uterus.
67. On Cancer.
68. On Scirrhus, and the Hard Tumour called Scleroma.
69. On Hole.
TO. On Inflation.
71. On Uterine Suffocation, or Ihe Hysterical ConTuIsion.
288
72. Od Prolapsus of the Uterus.
73. On Phimus of the Uterus.
74. Cure of Barreuness.
75. On Fissures, Condylomata, and Hemorrhoids.
76. On Difficult Parturition.
77. On Ischiatic Disease.
78. On Gout and Arthritis.
79. On Chilblains, and Complaints of the Sole and Heel.
80. For Corns and Callus.
81. On Complaints about the Nails, — and, first, of Paronychia.
PAULUS iEGINETA.
BOOK THIRD.
I. — On Affections of the Haitf Alopecia, Ophiasis, and
Baldness*
As some plants die from dryness for want of sap^ and some frdm
the sap being onsoitable to them, so is it in like manner with te
hairs ; for baldness is occasioned by want of the natural juices* aad
alopecia and ophiasis by the badness of them. These complidttts
di£^ only in figure ; for, in the latter, the affected part has tiie mp^
pearance cf a serpent; and alopecia deriTCS its appellation fnmt
the circumstance of foxes being frequently subject to the afieetiiNi.
Judging of the prevailing humour, then, from the colour of tite
skin, we are first to evacuate it by purging, and then to have re-
course to local appliditions. If, therefore, the colour incline to
black or white, we purge with the medicine called hiera, which
evacuates both phlegm and the melancholic humour ; but, if it is
palish, we give pills of aloes. An account of these medicines will
be found in that part of our work which treats of compound medi-
cines. After general depletion, we are to use masticatories oom'-
posed of vin^ar, mustard, and honey, and not once only, but fre-^
quently. It will be better, too, if marjoram, penny-royal, th3n]ie» or
hyssop, had been infused in the vinegar. In all the other compleliits
of the head, the same method is to be observed, first evacuating tiie
prevailing humour, either by purging, or by phlebotomy if there be
a fulness of blood, and then proceeding to the topical treatmmit.
On Alopbci a. -—Having first cleansed the part with nitre, and
scrubbed it with a rough cloth, more particularly a woollen-cloth«
and continued the friction until it become red, anoint it with yer-
vain pounded with vinegar in the sun. Or, rub in the roughest
alcyonium burnt and pounded with lamp-oil. Or, bum the root of
the club-rush, or the rind of the bitter almond, and rub theia in
with oil, or wolves* tallow. These are moderate remedies. But
236 PAULUS iEGINETA.
stronger applications may be prepared from euphorbium, thapsia,
and adarce, pounded with oil of bays, or liquid pitch. Another : —
Having burnt the shells of sea-urchins, mix them with wolves' tal-
low, and rub with them, having first cleansed the part with nitre.
Another : — Of pepper, of dried sheep's dung, of hedge- mustard, of
rocket-seeds, of each, dr. iv. ; of white hellebore, dr. iii. ; of mouses'
dung, dr. i : add to the gall of a bull, of a goat, or of a hog.
Another tried remedy for alopecia : — Of the root of mandragora, of
birthwort, of the root of wake-robin, of wax, of liquid pitch, oz.
viii. ; of swines'-seam not salted, of the heart or inner part of the
herb nerium a little : boil the seam and the nerium until the herb
be softened ; strain and throw away the herb, and add to the axunge
the other ingredients, and boil. Add the wax and the liquid pitch,
and use boldly in the sun. When the ulcers are cicatrised, burn
the head of a fox, take alcyonium, the leaves of the black alkanet,
and, having pounded all together, sprinkle upon the ointment, in or-
der to promote the growth of the hair. Another : — Of a mouse's
head burnt, one part ; of the shells of the sea-urchin, one part ; boil
in a pot with swine's-seam, and use. They may also be sprinkled
in powder.
A Medicament from Thapbia for all Chronic Affections. —
Of euphorbium, of thapsia, of bay -berries, of each, oz. i. ; of native
sulphur, oz. ss. ; of hellebore, oz. ss. ; of wax, oz. viij. ; of oil of
bays, or old castor oil, q. s. When stronger applications are re-
quired, add of cardamom, oz. i. ; of burnt alcyonium, oz. i. ; and it
will be applicable not only for alopecia, but for all cases of chronic
coldness. But in every case of tdopecia, have recourse in the first
jdace to the process of cleansing with nitre, then friction, and fre-
quent shaving. I have seen many have their hair reproduced by
friction alone, and frequent shaving.
For Baldness, and in order to Increase the Growth of
Hair, from Crito. — ^Take the dried stomachs of five hares, roast
carefully in an earthen vessel, add to them the third part of myrtle
tops, of the fruit of acacia, of the juice of acacia, of sweet-briir, an
equal part, of maiden-hair, oz. iii. ; pound all these things together,
and sift through a small sieve. Then, adding of wolves' tallow lb.
iv., of that of a seal the same quantity, pound, and preserve in a
leaden vessel. At the time of using, add to any fragrant ointment.
Preservatives of the Hair. — Of maiden-hair, one part; of
ladanum, two parts ; add to wine and myrtle-oil, and use. An-
other : — Pound the flower of anemone, and rub it in with oil. The
same will blacken the hair. Another : — Pound the straight vervain
dried with its roots, sift through a narrow sieve, and, having mixed
with oil so as to have the thickness of the bath-sordes, lay it up in
a copper vessel, and, when softened, use instead of oil in like
manner.
A Watery Infusion for Increasing the Growth of the
Hairs, and for Blackening them. — Of rain water, six sextarii ;
of Alexandrian sumach, three sextarii ; of maiden-hair, oz. iv. ; of
savin, oz. iv. ; of ladanum, oz. i. ; of m3Ttle, oz. i. ; of dried gourd,
BOOK THIRD. 287
OE. i. ; allow to macerate in a glass vessel for twenty days, stirring
it t^ice a-day with a pine spat^a. On the following day, plunge the
comb into the infusion, and use once a-day. And the seed of marsh-
mallows, when rubbed in while in a bath, preserves the hair, and
promotes its growth. And, in like manner, oil may be rubbed in
that has had marshmallows boiled in it, or added to it.
For Thinning thb Hair. — Of the leaves of the iig-tree, of liie
rind of the white wild vine, of pumice stone, of the shells of hoc*
cinse, of Cimolian earth, of each, one mina. Put them into a new
crude pot, and, having covered it with clay, bum in a furnace, and
pound, adding of aphronitrnm half a mina, of the galls called om-
phacitm thirty in number, pulverise and use. Another : — Of aphro-
nitrnm, half a mina ; of roasted pumice stone, four minse ; of fissile
alum (alumen scissilej, of dried iris, of the black wild myrtle, of
gum, of the root of bryony, of each, dr. iv. ; of unripe lupines
pounded, the fourth part of a gallon ; use without tallow.
For Falling out of thb Hair. — Rub in aloes with black aus-
tere wine ; or, the cover of the purpura boiled with oil ; or, m3nrh
and ladanum, with wine and myrtle oil ; or, pound burnt sheeps-
dung on a shell, and rub it in with oil, having first shaved the head.
II.— For making the Hair Curled, and for Dyeing them*
From Cleopatra,
Having first scrubbed the head, anoint the hair with the root of
cow-parsnip in undiluted wine. Another : — Having shaved the
head, and scrubbed it, take a young pine-kernel, and burn it until it
be reduced to ashes, put it into a mortar and pulverise it, adding
myrtle ointment, until it be of the thickness of honey, and thus anoint
the head with it. Another : — Rub in equal parts of myrtles and
beet, with oil. Another : — ^Twenty galls ; of maiden-hair, oz. ii. ;
pound with sea-water until they attain the thickness of honey.
Having rubbed the hair with urine or lixivial ashes, and cleaned
it with warm water, anoint it with this medicine for two days,
then stopping, on the third day clean it, and, having shaved, anoint
with myrtle oil. This will render the hair smooth, curled, and black ;
but it will be more curled if you will shave before using it.
Prbservativbs of Hoary Hairs, and other Compositions
FOR Dyking them Black. — Of the oil of unripe olives, three sex-
tarii ; of spikenard, dr. i. ; of unguis aromaticus (sweet-hoof f),
dr. iv. ; of schsenanth, dr. iv. Boil with oil, and separately pound
aud dissolve carefully one ounce of the juice of acacia in wine.
When only a third part of the oil remains, strain it, and, mixing
with the acacia, lay it up in a vessel, and anoint with it every day.
Another : — Of the bark of green walnuts, oz. iii. ; of the root of
the ilex, oz. iii. ; of dark-coloured wine, three sextarii ; boil to a
thirdrpart, and, having strained, pound the remainder with one
sextarius of myrtle oil. To be used every day.
An Infusion for Dyking the Hair Black. — Of galls, one
238 PAULUS iEGlNETA.
•extarius ; of elm-leaved Bumach (rhus coriaria), two sextarii ; of
the leaves of privet, an equal quantity ; of black myrtle leaves, the
same ; of cennaris, a handful ; of poppy-heads, the same ; of lake-
water, twelve sextarii. Macerate for many days, boil to a third,
then rub and anoint the head. When the hairs are dry, anoint
with an acetabulum of Cimolian earth, and an equal quantity of
quick-lime. Dissolving these things in the juice of boiled beet,
anoint with it, and then, for the sake of protection, put over it the
leaves of beet, and, when they adhere properly, wash in the bath
with it.
For Dyeing Tawnt Hair, and Making thbm of a Bright
YxLLOw Colour. — ^Take of m3m'h, one part ; of the flower of salt,
one part ; pulverise carefully, and, having made it of the thickness
of the sordes of a bath, scrub the head, anoint it with the ointment,
and allow it to remain a night and a day, and then order it to be
wiped off. Another : — Rub in unripe lupines with water. Another :
— Of litharge, dr. i. ; of Cretan earth, dr. iv. ; of quick-Ume., dr.
i. ; with water make to the thickness of bath sordes, and anoint.
Apply the leaves of beet for two or three days, and then dean.
For Making Black Hairs Yellow. — Add the lees of wine to the
sordes of a bath, and, having made it to the consistence of cerate,
use it when you are going to sleep, and in the morning the hairs
will be yellow. Another : — Macerate the leaves of privet in the
juice of Fuller's herb (struthiumj, and use the infusion.
A Gold- coloured Dye. — Of alum, dr. vi. ; of red arsenic, dr.
vi. ; of saffron, dr. ii. ; of the thapsus used by dyers, called rubia
by the Komans, dr. viij. ; of the lixivial ashes used by the bonnet-
makers, four sextarii ; boil the ashes and the thapsus pounded to-
gether, and, when but one-half remains, squeeze out the juice, and
dissolve in it the alum, red arsenic, and saffron ; put it into a glass
vessel, and, at the time of using, first scrub the head, and then
anoint with it. When it is all drunk up, clean with the decoction
pf fenugreek, barley, and cumin, having previously washed them
with a sufficiency of tepid water, and add as much as is required.
Another : — Mixing together the burnt lees of wine and the oU used
in the baths, anoint the hairs. Another : — Scrub with Gallic soap
and water at each bath. Another very fine : — Of red sumach, a
sextarius ; of galls, lb. i. ss. ; of sheeps' dung, oz. ii. ; of the
golden-coloured herb, called rubia by the Romans, oz. ii.; of
maiden-hair, two fasciculi ; of wormwood, one fasciculus ; of lu-
pines stripped of their outer coat, two cyathi ; of water, six sex-
tarii ; put all into a glass vessel, and allow to macerate for nine
days, stirring it twice a day. At the time of using, strain out
what is required, and, soaking a sponge in it, rub the hairs, and
when they are moistened allow them to drink it up. When dried,
wash with a solution of soap in warm water.
For Making the Hair White. — Bum the flowers of the white
petty-muUein, moisten with vinegar, and mix for a detergent
ointment. Another : — Of the fruit of petty-mullein, dr. i. ; of
BOOK THIRD. 299
alum, dr. i. ; of the rind of radbbes^ dr. i. ; pound, and mix of
bulla' gluten, dr. iy.
Ilh-^On Pityriani.
PiTTBiABis is an eruption of small furfuraceoua aubstancea on the
skin of the bead, or the rest of the body, without ulceration. It ia
occasioned, either by depraved humours which have been determined
to the bead, or by a saltish phlegm, or by bilious or melancholic
blood. After the general system has been evacuated, as formerly
described, we must use some of the under-mentioned remedies.
Macerate Cimolian earth in water, mix with the juice of beet, and
anoint with it, allowing it to remain until dry, then wash it away,
and, having pounded frankincense with wine and oil, anoint with
them. Next day, rub in stavesacre with oil. Another : — Of nitre,
of the burnt lees of wine, of ben nut, of each, lb. i. ; of stavesacre,
lb. i. ss. Dissolve in wine, and rub the head ; or, if the rest of
the body be affected with tingling, it may be used dry. When the
Pityriasis is more humid, wash with brine or the decoction of
lupines. Of this remedy I have had ample experience.
On Pstpracia ANn Exanthemata of thb Hbad. — ^The psydra^
cia are small protuberances, like blisters, elevated above the skin.
The exanthemata are superficial ulcerations, somewhat red and
rongh. Both are to be cured by the under-mentioned remedies :—
Of Utbarge, dr. iv. ; of ceruse, dr. iv. ; of alum, dr. ii. ; of the green
leaves of rue, dr. ii. ; pound with vinegar and myrtle oil, and anoint.
Another :— -Pounding rue and alum with honey, anoint with this
the bead, after having first shaven it. If the head is excoriated,
^ply olive leaves boiled with honey. Another : — Of litharge and
cemse, <^ each, dr. xii. ; of native sulphur, dr. viij.; mix witi^
myrtle cerate.
For thb Thick ANn Rsn Ulcbrs of thb Hbad rb8bmbi»im«
Papuiijb, or small Nipplbs, from which Ichor is discharobp.— p-
Having first shaved the head and scrubbed it with water and
nitre, use native sulphur livigated with human urine ; or anoint
with melantena and vinegar.
For Achorbs and Favi. — The complaint called achor is one
of those which affect the skin of the head, corroding the skin by
very small perforations, from which a discharge of viscid humour
takes ]^Ace. The complaint called favus is nearly allied to it in
appearance, since it consists of larger perforations resembling the
combs of bees, containing a honey*like fluid. They are occasicmod
by a nitrous and saltish phlegm. In such cases, the diet should
consist of wholesome food ; and every thing that is acrid and saltish
should be avoided, more particularly if the attack be inflammatory.
After the proper evacuation of the prevailing humour, having
shaven the hairs, foment twice, thrice, or oftener, with warm water,
in which has been boiled myrtle, or bramble, or lentil, or bitter
lupines, ot the root of asparagus. When the ichorous discharge is
240 ^AULUB JSOINSTA.
greater, 9l^\j a cataplasm of the leaves of willow, with water, or
of lentil. The ointments used should consist of Cimolian, Cretan,
or Samian earth, or pomphol3rx, or spodium, or litharge, or cad-
mia, or humt paper, or the powder from pepper. All these are
to be applied with vinegar. We may use the following smegma : —
Of snlphur, of the herb perdicias, and soap, of each, equal parts.
Tke following are compound applications :— Of litharge, dr. xvi. ;
of the leaves of me, dr. viii. ; of the stavesacre, dr. iv. ; of copperas,
dr. ii. ; with vinegar and myrtle oil ; make to the consistence of bath
sordes, and anoint with it. Another : — Of sand3rx (calcined ceruse?) ,
dr. iv. ; of myrrh, dr. iv. ; of native sulphur, dr. ii. ; of manna, dr.
iv. ; rub into the part with old oil.
For Achorbs. — ^When they discharge ichor, triturate the dross
of silver, or yellow ore of lead (molyhdoBna) , and sprinkle upon them.
Another, for achores and humid psora :---Of the roses of the rho-
dodaphne, oz. iv. ; of native sulphur, oz. iv. ; of liquid pitch, oz.
iii. ; of dry pitch, oz. iii. ; of wax, oe. vi. ; of myrtle oil, q. s,
FcH* children, dissolve in milk, and anoint.
For Fici. — We give the name of fici to ulcerous excrescences
which are round, somewhat hard, red, and accompanied with pain.
They arise for the most part on the head, but iJso sometimes on
the other parts of the body. The best application for this com-
pbunt, consists of fissile alum ; of the calcined flowers of copper ;
of taurocolla, of each equal parts, with double the quantity of the
flakes of copper ; triturate with vinegar, and anoint. A proper
application is also prepared from the burnt heads of the cackrel fish,
the bulbi boiled, and their ashes mixed with vinegar.
A DRT APPLICATION FOR FlCOSB ERUPTIONS OF THB HbAD AMD
Chin. — Of misy, dr. i. ss. ; of chalcitis, dr. ii. ss. ; of squama
seris, dr. i. ; of fissile alum, dr. i. Having washed, apply this in
a dry state unsparingly, and allow it to remain. Next day, having
again washed, wipe the part with a sponge, and apply it again. A
thick scab will then fall from the ulcer. Repeat the same applica-
tion the following days. The cure will be efiected in a few days
without leaving a cicatrix ; but this medicine operates strongly.
For Licb in thb Hbad. — Direct to scrub the head with the decoc-
tion of lupines ; or pound together stavesacre and sandarach, and
rub them in, along with oil or vinegar ; or a small quantity of
pepper may be added to old oil, so as not to occasion ulceration ; or
the juice of ivy with honey may be used ; or mustard and vinegar;
or the gum vernix, or liquid pitch with alum ; or the expressed juice
of the bay berries ; or oil of radishes. I have always succeeded by
pounding stavesacre with vinegar and oil, and anointing with
this.
l\.—On Headach.
Hbadach, which is one of the most serious complaints, is some-
times occasioned by an intemperament solely ; sometimes by a re '
BOOK THIRD. 241
dandance of humours, and sometimes by both ; and sometimes it is
occasioned by a procatarctic cause, such as external heat, or cold,
or drunkenness, or a blow. The most vehement pains of the head
are excited by the active qualities, particularly heat. Those occa-
sioned by dryness are not equally vehement ; but a humid quality
excites no pain of itself, unless it happen to be joined to heat,
cold, or a fulness of humours. Headachs occurring in a fever
having been treated of in the Book on Fevers, we will now treat
of the others. *
On Hbadach from Heat. — When headach proceeds from ex-
posure to heat, the skin feels hotter and drier than natural at the
first application of the hand, and the eyes of such persons are red.
They delight in cold afflusions and ointments, and are benefited by
them. The method of cure will correspond with that described as
applicable for cases of headach in fevers. When the pain becomes
chronic, we must have recourse to some of the under-mentioned ap-
plications. The following applications to the forehead and temples
vrill also be proper, namely, bread soaked in oxycrate and rose-oil,
to which may sometimes be joined almonds ; or roses either dried or
fresh, or mixed with mint and penny-royal ; or bread with the leaves
of the peach tree. Benefit may also be derived from basil, pounded
^th vinegar and rose-oil ; or from ivy berries boiled in vinegar,
and pounded with rose-oil ; or from wheaten flour mixed with the
yffKtiry decoction of wild thyme ; or from cardamom toasted and
triturated in vinegar and rose-oil ; or from yeast with rose-oil ; or
from dried iris with vinegar. These applications must be changed
frequently ; for, if allowed to remain long, they have no effect.
TitOCHISKS FOR HbADACH OCCASIONED BT A WaRM InTEMPBRA-
^SNT. — Of safiron, dr. v. ; of copperas, dr. x. ; of alum, dr. xvi. ;
of myrrh, dr. vii. ; of the oil of unripe olives, dr. iii; of chalcitis,
dr. iii. ; of gum, dr. iii. ; of austere wine, q, s. Use with oxy-
crate, and, if watchfulness accompany it, add some soporific.
On Hbadachs from a cold Intbmpbrament. — In cases of head-
achs from coldness, the symptoms are just the reverse of those pro-
ceeding from heat ; for the face is pale and not contracted, and the
patients do not delight in cold things, nor arc benefited by them.
The diagnosis will also be confirmed, by adverting to their di^
and the like. The ointments applied should contain rue, or the
oil of bay, or of iris, or of nard, or the juice of balsam, more par*
ticularly if the excrementitious humours be thick and viscid. This
must be rubbed into the forehead, and likewise preparations con-
teioing pepper and euphorbium. We must also give attenuant
%vines, and recommend exercise, hot baths, and occasionally an
emetic from radishes. When the exciting cause is a chronic
quality without plethora, we may use the following application :—
Of white pepper, dr. ii. ; of croco-magma, dr. ii. ; of fresh euphor-
l)ium, dr. viii. Ss. ; of pigeon's dung, dr. i. Ss. ; of the strongest
vinegar, q, 9, Having first rubbed the affected part, anoint with
this.
On Hbadachs from a Bilious Humour. — ^The symptoms re-
r
242 PAULUS iEGINETA.
semble those occasioned by heat, only there are more gnawing pains
at the stomach, paleness of the countenance, and sometimes a bitter
taste in the mouth. This affection occurs most frequently in adults
who are of a hot temperament, lead an anxious life, and are subject to
collections of yellow bile. They must use tepid baths, and mild
ointments, with a watery drink ; and their whole diet should be
humid, and consist of good juices. The bilious humours must be
evacuated with the decoction of worm-wood, or with aloes, or the
antidote called hiera picra, either alone, or in combination with a
little scammony, or the aloetic pills. The forehead is to be rubbed
with the saffron trochisk, that called Trigonos, or the like.
On Hbadach from Sympathy. — If the head be affected sympa-
thetically with the general system, this must be our first care, by
attending to the intemperament and the prevailing humour. If it
proceed from plethora, more especially a venous one, we will bleed ;
but, if it be only an offending quality, we must use a purgative
medicine. If the head sympathise with some particular part, such
as the liver, belly, or stomach, we must apply remedies to these
organs. If a hot intemperament accompany, we give bread which
has been steeped in a watery wine, or spoon-meats from chondrus.
Moderately cooling and tonic applications are likewise to be used ex-
ternally, as formerly described. But, if the headach be occasioned
by viscid and thick humours contained in the stomach, these must
be dislodged by drinking oxymel, either alone, or that preparation
called the Julian. We must also use decoctions of hyssop and mar-
joram, and other things still hotter and more incisive, and likewise
the emetic from radishes, hot embrocations, and cataplasms.
On Hbadach from Wink. — If the wine remain undigested, we
must procure vomiting, by drinking tepid water ; but, if the head-
ach remain after digestion, we must use cooling and repellent ap-
plications, such as rose-oil alone and with vinegar, or the juice of
ivy, or of cabbage. And the leaves of cabbage infused in warm
water, and applied to and bound to the head, naturaUy coimteract
intoxication. They must also eat boiled cabbage. Dried len^l is
also beneficial, particularly to those who have a loose belly. They
ought likewise to eat alica, pomegranates, apples, and pears, and
drink water.
On Hbadach from a Blow. — ^We must immediately bleed those
who have headach from a blow (unless the injury be superficial),
and use suitable embrocations to the head ; bathe it with sweet oil ;
cover it with wool ; and make the patients abstain from wine and
a rich diet, more especially if they have fever ; and, upon the whole,
we are to accommodate our treatment as for the infiammation of
nervous parts, and especially of the membranes of the brain. If
there be a wound it must be treated accordingly.
An Emollibnt Application for Hbadach. — Of wax, dr. vii. j
of almond oil, oz. iii. ; of turpentine, dr. viii. ; of scraped verdigris,
of Cimolian earth, and of chalcitis, of each, dr. iv. ; of
stone, dr. iii. ; of burnt copper and scales of steel (squanue siemo-
BOOK THIRD. 248
math), of each, dr. ii. ; and, if it appear to be too hard, soften it
with almond oil.
V. — On CephaUea and Hemicrania,
Each of these affections is a permanent pain of the head, liable
to be increased by noises, cries, a brilliant light, drinking of wine,
and strong-smelling things which fill the head. Some feel as if
the whole head were struck, and some as if one-half, in which case
the complaint is called hemicrania. When the affection is seated
within the skull, the pain extends to the roots of the eyes, and
when externally it spreads around the skull. Pain, then, accompanied
with heaviness, indicates plethora ; if with pungency, acrimony of the
humours or spirits ; if with throbbing, inflammatioti ; if with tightness
and without heaviness and throbbing, a fulness of a thin and fla-
tulent spirit (gas?) ; but, if it be attended with throbbing, it is in-
dicative of inflammation of a membrane ; if with heaviness, of a ful-
ness contained within the membrane. If the putrid humour acquire
heat, the headach will be attended with fever. And, ii) general,
those in whom headach proceeds from inflammation have fever.
When, therefore, the whole body is in a plethoric state, we must
bleed (attention being paid to the strength), and use the more acrid
clysters. Should there still appear to be a fulness of blood, we
must open the veins of the nose, and endeavour to evacuate there-
by to a sufficient amount. We must then give hiera sharpened
with vinegar, and use masticatories, or medicines for evacuating
the phlegm by the mouth ; also procure evacuations from the nose
by means of errhines, such as the juice of elaterium, which may be
poured in with milk ; or the elaterium may be snuffed up dry, or
else the juice of sow-bread or of leeks. The following are com-
pound medicines : —
An Errhinb for Chronic Headachs, Ophthalmt, and Epi-
X.EPST. — Of gith (mgeUa sativa), dr. viij. ; of sal ammoniac, dr. iv. ;
of elaterium, dr. iv« ; pound and mix with Sicyonian oil, or that of
iris, or of privet, so as to have the thickness of cerate, and apply to
the nostrils.
An Errhine to be Snuffed up. — Of dried sow-bread, dr. viij. ;
of red nitre, dr. iv. ; or, if instead of the nitre, you will use ela-
terium, it wiU be still better. Snuff it up through a reed. In more
chronic cases, use epithemes to the head and unguents, as the fol-
lowing : —
An Epithemb for Cbphaljea. — Of the ointment of iris, of hogs-
femael and castor, of each, dr. i. ; of bay-berries, dr. ii. ; of the tops
of rue, dr. iv. ; mix with rose-cerate, and, having shaven the head,
apply to the whole of it. A certain woman, by using the following
application in cases of hemicrania, acquired wonderful celebrity : —
Having cut down the green root of the wild cucumber into small
pieces, she boiled it and worm- wood in oil and water until they
were softened ; and, with the warm oil and water she fomented
r2
244 PAULUS ^GINETA.
moderately the affected part ; and, pounding the root and the worm-
wood, she made a cataplasm of them. And with this application
she cured cases of hemicrania, both with fever and without. When
a strong paroxysm takes place, so that the pain is insupportable,
use paregoric and alterativie applications like the following : —
An Unguent for Cephaljba. — Of the juice of hog*s-fennel, dr.
xvi. ; of the juice of poppy, of anise, of henbane, of sa^on, of
myrrh, of scammony, of each, dr. ii. Add to vinegar and make
trochisks. When using it, anoint those who have pain of the head
from thick humours or a flatulent spirit with it, along with vinegar
or oxycrate. We must, likewise, use a dropax and sinapism, and
the trochisk from thapsia. That, too, from writing ink is much ap-
proved of for the same cause, and is to be used, as will be described
in the Book on Compound Medicines.
The following one is possessed of wonderful efficacy for hemi-
crania proceeding from a thick and viscid humour : — Of euphor*
bium, one part ; of castor, an equal quantity ; and, mixing with
water, insert into the ear of the affected side, and order the patient
to go into a bath, and, when he has remained a short time, take it
out, and bathe as usual. Thus it is of tried efficacy. It will not be
improper also to add them to oil, and inject into the ear. The ap-
plication described for ischiatics is likewise a successful remedy for
chronic headach and hemicrania.
For Chronic Hemicrania. — Of garlic, dr. iv. ; of wax, dr. ii. ;
of old axunge, dr. ii. ; of cantharides, dr. ii. Apply this in the
evening, and, having allowed it to remain all night, break the blis-
ter in the morning, and cure with the plaster called Panygms.
Another : — Of bay-berries stripped of their skins, dr. ii. ; of the
leaves of rue, dr. ii. ; of mustard, dr. i. ; moisten with water, and
apply. It is most beneficial to those whose complaints arise from
cold causes, so that frequently, when applied before going into the
bath, it immediately cures the affection, and after the bath they
become perfectly well. Another: — Of Sabine oil, lb. i. ; of wax,
oz. iii. ; of euphorbium, oz. i. ; with this anoint the half of the
forehead, namely along the temporal muscle. If the cold is not
great, pound galls and crocomagma in equal quantity with wine,
and anoint. In cases from hot fumes or humours, do not use the
applications with euphorbium.
An Apophlegmetism, or Masticatory, for Cbphaljba and
Hemicrania. — Of mustard pulverised and dissolved in vinegar and
honey, oz. xiv. ; of stavesacre, dr. iv. ; of pellitory, dr. iv. ; having
pounded, strained, and mixed in the sun, gargle with it. When
the cephalsea becomes permanent, owing to a bilious humour or
some intemperament, use the remedies formerly described for head-
ach. If after all this the pain continue, even after cupping and
leeching, and there is reason to suspect that the distribution by the
arteries is affected, it will not be improper to open the arteries be-
hind the ears. In those of a humid intemperament, the natural
baths may be tried with good effect. Another for hemicrania : —
BOOK THIRD. 245
Mix euphorbium and earth-worms with vinegai^ and anoint the af*
fected part, or the whole forehead.
« VI. — On Phrenitis,
Phrbnitis is an inflammation of the membranes, the brain also
being sometimes inflamed along with them, and sometimes a preter-
natural heat fixes originally in the brain itself. The cause of this
disorder is either a fulness of blood, or of a yellow bilious humour ;
and sometimes the yellow bile, being excessively heated and con-
verted into the black, becomes the cause of the worst species of
phrenitis. And sometimes the affection arises from the brain sym-
pathizing with the diaphragm by means of the nerves distributed
upon it. But the aberration of intellect which occurs at the acm^
of very hot fevers, and that which is occasioned by sympathy with
the stomach, is not called phrensy but delirium. Cases of true
phrenitis are, for the most part, attended with watchfulness, bat
sometimes with disturbed sleep, so that the patients start, leap up,
and cry out furiously ; when the complaint is occasiomed by a san-
guineous humour, with laughter ; but when by yellow bile, with
ferocity ; and when by a black, with unrestrainable madness.
They forget what is said and done by them, their eyes are blood-
shot, and they rub them ; they are sometimes squalid, sometimes
filled with tears, or loaded with rheums. The tongue is rough,
there is a trickling of blood from the nose, they pick at flocks of
Wool and gather chafl^, and have acute fever during the whole con-
tinuance of the disorder. When a fever of a bad character is seated
deeply, they have the pulse small and indistinct, with a certain de-
^ee of hardness. The respiration is large and rare when the brain
is primarily aflfected. And, if the phrenitis be occasioned by sym-
pathy with the diaphragm, the respiration is irregular, the hypo-
chondria are retracted and hot ; but, when it arises from sympathy
with the brain itself, the parts about the face are hot and suffused
"^vith blqod, and the veins are full. When a pituitous humour is
rnixed with the bilious, as the cause of the disease is compound, so
a.l80 is its appellation ; for it is called Coma vigil. When a bilious
Ixnmour prevails, persons so affected are troubled with watchfulness;
^nd, when a pituitous is the cause, they lie in a state of Coma. Be-
fore Galen, this disease was called catochus, but since then it has
en called catoche and catalepsy.
Thb Curb of Phrenitis. — If the strength admit of blood-let*
ng, we are to abstract blood from the arm immediately and
^ireely ; but, if the patient be delirious and will not present his arm,
^^x if there be apprehension of hemorrhage after the bleeding from
'tlie patient tearing his arm during the agitation of his delirium, we
^^nust open the straight vein in the forehead, and take away at once
^ sufficient quantity of blood. We are to use clysters and injec-
tions of oil, or rose-oil with the juice of ptisan. When watchful-
ness prevails, we anoint the head with rose-oil, or with vinegar and
246 PAULUS yEGlNETA.
rose-oil ; iii some cases fomenting it with hot water ; and we must
give the medicine from the heads of poppy, unless prevented by the
weakness of the patient's powers ; and must have recourse to the
other remedies for insomnolency formerly mentioned. Let the pa-
tient be laid in a place which is in a moderate state as to light and
temperature, and let there be no paintings in it, for these are apt
to excite emotions in such casres. J^et some of his most beloved
friends come in and converse with him in a suitable manner, some-
times gently soothing him, and at other times chiding him more
harshly. His food at first should consist of honied water, and ^ter-
wards of the juice of ptisan, or spoon-meats formed from chondras,
with some sweet potion, such as apomel, or hydroroeatum, or rho-
domel, or the sweet hydromel. But the vinous hydromel which is
brought from Cebyra in small vessels must be rejected, as it pro-
duces more mischief than wine itself, especially in afiections of the
head and before concoction. We are also to administer bread that
has been soaked in water, and succory, and boiled lettuces. Or, if
there be much effervescence, they may be given raw, and also the
medullary part of the cucumber, of the pompion, of apricots, and
the like. They must abstain from cold water, more especially if
the afiection be found to proceed from sympathy with the dia-
phragm. If their urine (as is likely) be retained, owing to their
delirium, we must foment the lower part of the belly and bladder
with warm oil and water, and then, by applying the fingers of the
hand to the part, we must try to incite him to make water. We
must also anoint the rest of the body with warm oil ; and the pa-
tients are to be kept in a recumbent postm'e, for a state of quie-
tude is to be maintained as much as possible ; and, if they be rich,
they are to be restrained by their servants ; but, if not, they are to
be bound with ligatures. For irregular motion is apt to produce
prostration of the strength. And for another reason, too, the feel
ought to be bound with ligatures after having been bathed, and
friction applied to them, namely, for the sake of revulsion. But. if
the attack be more protracted and difficult to remove, we must ab-
stain from all narcotics ; and to the fomentations of the head are to
be added things of a discutient nature, such as the juice of mint, or
of wild thyme, or of calamint, or of rue ; and then we must use :
errhines. After the seventh day, if the viscera be inflamed, we
to soothe them by cataplasms of linseed and raw barley-flour ii
oil and water. We are then to apply dry cupping or cupping witfac^
scarifications to the parts, and to the back-part of the head and th^^
spine. But, if the body be observed to be very squalid and hot cJ
even if the fever remain, we must use baths of fresh water, ai
plentiful anointing, and give some thin and weak wine, in order
rouse the strength ; for we need not apprehend any mental alieni
tion that will thereby be produced. For, either it will not
place at all, as the disease is on the decline, or, if it do, it may
easily removed. When the disease further abates, we must bai
recourse to gestation and suitable restoratives. Recovery may
BOOK THIRD. 24/
promoted by avoiding intoxication, anger, indigestion of the food,
and more especially exposm'e to the heat of the sun.
VIL — On Phlegmon of the Brain.
Whbn the brain is inflamed, it is often so swelled that the su*
tares of the skull are separated. The pain is very strong and per-
manent ; there is much anxiety, and much redness of the counte-
nance, with swelling ; the eyes protrude, and the head swells. We
must let blood from the arm, and also detract by the nose, and from
the vessels below the tongue. We are also to use the fomentations
suitable for inflammations of the head, and cataplasms of a moist-
ening and concocting nature.
VIII. — On Erysipelas of the Brain,
Ebtbipblas occurs also in the brain, and the patient suffers in
the following manner: — He has pain of the whole head, and feels
as if there were fire in it ; his face is cold and pale, and his mouth
dry. Wherefore, bleed such a patient, and more particularly ab-
stract blood from the veins under the tongue, and apply cooling
things, such as we use in other kinds of erysipelas.
IX. — On Lethargy.
Lbthargt, which is a lesion of the rational part, has the same
^eat as phrensy, I mean the brain, but the matter which causes it is
of an opposite nature ; for it is occasioned by a humid and cold phlegm
irrigating the brain. It is attended with an obscure fever, which
is not very pungent, and with somnolency. The pulse is large,
rare, and imdulatory ; the respiration is very rare and weak. Le-
thargies are altogether disposed to sleep ; are roused with difficulty ;
can scarcely be made to answer questions ; are forgetful and deli-
rious ; they yawn frequently, and remain sometimes with their jaws
distended, as forgetting to shut their mouths ; their evacuations by
the belly are generally watery, but sometimes on the contrary the
^Uy is dry ; their urine is like that of cattle. Some have trem •
Idlings and sweatings. Garus being occasioned by the same matter
«us lethargy differs &om it in this, that fever precedes cams, and is
more violent, whereas it is subsequent in lethargy; and in this
respect also, that cams often supervenes upon other complaints, for
it often follows paroxysms of fevers, epilepsy, and compression
of the brain, as from the bone in fractures, or from the meningo-
phylaX pressing upon the anterior ventricle of the brain ; whereas
lethargy has a certain peculiar formation.
Thb Curb of Lbtharoy. — When the strength permits, we must
open a vein ; but, when it does not, we must use acrid clysters. We
248 PAUl^US ilCGlNETA.
must also lay the patient in an apartment of large »ize, and having
a moderate degree of light, and apply to the head an embrocation
of oil to which castor has been added. Some instead of the oil
use vinegar and rose- oil with the castor, by which they strengthen
and warm the head at the same time. And, having anointed the
rest of the body, particularly the extremities, with old oil, they sti-
mulate them with calcined nitre, pellitory, pepper, or the granum
cnidium. It is also possible, by making them into a cerate with
castor, to use them in this way. We must likewise apply strong-
scented things, triturating thyme, maijoram, and penny-royal, with
vinegar. We may smear the mouth and palate with mustard
I>ooHded in a small quantity of honey, and we may even remove
with the lingers the phlegm which adheres to it. And, rf they will
admit it, it is proper to use a masticatory consisting of oxymel with
hyssop, penny-royal, maijoram, or mustard itself. We may give
also in their drink things of a diffusible nature, more particularly
the Diospolites, to the amount of a spoonful, with oxycrate. When
there is chronic trembling, we must give two or three scruples of
castor ; or, if there be a redundance of humours, and there be no-
thing to contra-indicate the use of it, we may add a scruple of
scammony to the castor. When the disease is protracted, the head
must be shaven and fomented with salt, millet, and the like, in
small bags ; and sinapisms are to be applied to the whole head, and
medicines used to excite sneezing. Afterwards we may apply dry
cupping, with much heat, or cupping with scarifications, to the back
part of the head. It will be necessary to attend to the natural eva-
cuations by means of clysters and diuretics. Apply to the lower
part of the belly an embrocation with oil of rue, or Sicyonian oil
with some castor. We must also attend particularly to the deglu-
tition, injecting, by means of a vessel with a narrow mouth, warm
water, to which has been added some sweet potion, more especially
apomel. And, if there be inflammation in the intermediate parts,
we must cure it with embrocations and cataplasms. To the nose is
to be applied mustard triturated with vinegar, or burnt castor.
Their food should consist of ptisan, or the decoction of uats, or that
of alica, with oxymel, salt, or penny-royal, sometimes giving of it
every day, and sometimes only every alternate day. After food,
ligatures are to be applied to the extremities, which may also be
bent back ; and the limbs are to be pinched, and sometimes we may
even tear the hair violently in order to rouse them. Rubefacients
to the thighs and legs are also proper. When the affection is in
the decline, we may enjoin proper gestation, direct the bath to be
taken, and a restorative diet to be used.
X. — On CatochuSy or Coma Vigil.
Wk have already in treating of phrenitis mentioned the forma-
tion of this disease, the symptoms whereof in general are the sams
as those of phrenitis and lethargy, being modified according to th-
BOOK THIRD. 249
prevailing matter. The peculiar symptoms are these : — Tlie patieutt
remain fixedly stretched in a sapinc posture, having sometimes
their countenance somewhat swelled and livid like those in lethargy,
and sometimes with a florid redness in it; the upper eyelid seems
drawn upwards and projecting so that they cannot wink. They
seem also not to hreathe, but to be as dead. The pulse is small,
indistinct, and very dense. The discharges from the bowels and
bladder are suppressed, or in small quantities. When the attack ia
moderate, they drink whatever fluid is poured into the mouth ; bat
those who are overpowered by it reject the same by the nose.
Those, therefore, in whom the phlegm prevails over the bile, we
distinguish from those affected with lethargy by this, that there is
no swelling present, nor is the colour livid like lethargies, except
to a very small degree ; and that they perspire moderately. The
cases are difficult in which there is much watchfulness, the urine is
suppressed, the difficulty of breathing is intense, when they have
sweats, and the drink regurgitates by the nose. If it be a woman
that is affected, the complaint may be distinguished from uterine
suffocation, by the circumstance that she lies in a natural state, is
sensible when spoken to, can be roused, but sinks again into a state
of sopor. Some say that catochus is a different 
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